Provider Demographics
NPI:1821975459
Name:HYDRAFIT WELLNESS, LLC
Entity type:Organization
Organization Name:HYDRAFIT WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARDEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:408-230-7679
Mailing Address - Street 1:3277 S WHITE RD # 228
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-4056
Mailing Address - Country:US
Mailing Address - Phone:408-230-7679
Mailing Address - Fax:
Practice Address - Street 1:2741 CHOPIN AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-1310
Practice Address - Country:US
Practice Address - Phone:408-230-7679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy