| Ebenezer Wellness Center, Inc. | |
|
16261 Laguna Canyon Rd Suite 100 Irvine CA 92618-3608 | |
| (714) 636-3886 | |
| Not Available |
| Full Name | Ebenezer Wellness Center, Inc. |
|---|---|
| Speciality | General Practice |
| Location | 16261 Laguna Canyon Rd, Irvine, California |
| Authorized Official Name and Position | Junghee Kim (VICE PRESIDENT) |
| Authorized Official Contact | 7146183942 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ebenezer Wellness Center, Inc. 16261 Laguna Canyon Rd Suite 100 Irvine CA 92618-3608 Ph: (714) 636-3886 | Ebenezer Wellness Center, Inc. 16261 Laguna Canyon Rd Suite 100 Irvine CA 92618-3608 Ph: (714) 636-3886 |
| NPI Number | 1114339272 |
|---|---|
| Provider Enumeration Date | 05/23/2014 |
| Last Update Date | 05/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114339272 | NPI | - | NPPES |
| A86714 | Other | CA | CA MEDICAL BOARD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A86714 (California) | Primary |
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