| Health And Wellness Center, Inc. | |
|
23672 Birtcher Rd. Unit A Lake Forest CA 92630-1711 | |
| (949) 770-7301 | |
| (949) 770-0634 |
| Full Name | Health And Wellness Center, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 23672 Birtcher Rd., Lake Forest, California |
| Authorized Official Name and Position | Mohammed Mahmood Ali (PROVIDER) |
| Authorized Official Contact | 9497707301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health And Wellness Center, Inc. 23672 Birtcher Rd., Unit A Lake Forest CA 92630-1711 Ph: (949) 770-7301 | Health And Wellness Center, Inc. 23672 Birtcher Rd. Unit A Lake Forest CA 92630-1711 Ph: (949) 770-7301 |
| NPI Number | 1386802940 |
|---|---|
| Provider Enumeration Date | 05/29/2008 |
| Last Update Date | 03/06/2020 |
| Medicare PECOS PAC ID | 6204996861 |
|---|---|
| Medicare Enrollment ID | O20081201000018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386802940 | NPI | - | NPPES |
| 00A836880 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Mohammed M Ali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053405506 PECOS PAC ID: 6204806540 Enrollment ID: I20040726001379 |
| Provider Name | Lesa Marie Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730896333 PECOS PAC ID: 9638529159 Enrollment ID: I20231226001577 |
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