Provider Demographics
NPI:1760202873
Name:THE WELLNESS INSTITUTE
Entity type:Organization
Organization Name:THE WELLNESS INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:WILL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-384-2476
Mailing Address - Street 1:5565 GROSSMONT CENTER DR STE 256
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3098
Mailing Address - Country:US
Mailing Address - Phone:844-384-2476
Mailing Address - Fax:844-384-2476
Practice Address - Street 1:3252 HOLIDAY CT STE 211
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-0027
Practice Address - Country:US
Practice Address - Phone:844-384-2476
Practice Address - Fax:844-384-2476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-14
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty