| NPI | 1053705228 |
|---|---|
| Doing Business As | BEVERLY HILLS WELLNESS PHYSICIAN CORP |
| Entity Type | Organization |
| Authorized Contact | EDWARD BRENT LAUGESON Manager 818-518-5980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: CA G44674) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: CA G28478) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA G44674) | |
| 208D00000X General Practice (Licence: CA G44674) | |
| 363A00000X Physician Assistant (Licence: CA PA11755) | |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: CA G44674) | |
| 106H00000X Marriage & Family Therapist (Licence: CA LMFT77740) | |
| 207QB0002X Family Medicine, Bariatric Medicine (Licence: CA G56249) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: CA A063319) | |
| 207W00000X Ophthalmology (Licence: CA G56249) | |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2020-01-15 |