| Nourishing Wellness Inc | |
|
819 N Harbor Dr Suite 310 Redondo Beach CA 90277-2006 | |
| (310) 373-7830 | |
| (310) 373-7840 |
| Full Name | Nourishing Wellness Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 819 N Harbor Dr, Redondo Beach, California |
| Authorized Official Name and Position | Allen Peters (OWNER) |
| Authorized Official Contact | 3103737830 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nourishing Wellness Inc 819 N Harbor Dr Suite 310 Redondo Beach CA 90277-2006 Ph: (310) 373-7830 | Nourishing Wellness Inc 819 N Harbor Dr Suite 310 Redondo Beach CA 90277-2006 Ph: (310) 373-7830 |
| NPI Number | 1336321520 |
|---|---|
| Provider Enumeration Date | 11/29/2007 |
| Last Update Date | 04/15/2020 |
| Medicare PECOS PAC ID | 9234135435 |
|---|---|
| Medicare Enrollment ID | O20061011000486 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336321520 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G16945 (California) | Primary |
| Provider Name | Allen H Peters |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1881608909 PECOS PAC ID: 3678579885 Enrollment ID: I20061011000517 |
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