| NPI | 1912278664 |
|---|---|
| Former Legal Business Name | OPTIMAL WELLNESS |
| Entity Type | Organization |
| Authorized Contact | JORGE L MORENO Practitioner / Physician 323-726-6289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA 20A6911) |
| Additional Taxonomies | 175L00000X Homeopath |
| 204R00000X Electrodiagnostic Medicine | |
| 207QB0002X Family Medicine, Bariatric Medicine | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine | |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2021-06-28 |