Provider Demographics
NPI:1255218186
Name:LIFE AND NATURE WELLNESS INC
Entity type:Organization
Organization Name:LIFE AND NATURE WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SOO JIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:949-839-3259
Mailing Address - Street 1:1000 N ROANNE PL
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-3206
Mailing Address - Country:US
Mailing Address - Phone:949-839-3259
Mailing Address - Fax:
Practice Address - Street 1:520 N BROOKHURST ST STE 204
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5236
Practice Address - Country:US
Practice Address - Phone:714-443-1779
Practice Address - Fax:855-224-7041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251K00000XAgenciesPublic Health or Welfare
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)