| Yong At Heart Total Wellness | |
|
16838 Clark St Ste C Encino CA 91436-1066 | |
| (818) 789-0203 | |
| (818) 789-0208 |
| Full Name | Yong At Heart Total Wellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 16838 Clark St Ste C, Encino, California |
| Authorized Official Name and Position | Marjorie Meiji Yong (PRESIDENT) |
| Authorized Official Contact | 3109891892 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yong At Heart Total Wellness 16628 Oak View Ct Encino CA 91436-1900 Ph: (310) 989-1892 | Yong At Heart Total Wellness 16838 Clark St Ste C Encino CA 91436-1066 Ph: (818) 789-0203 |
| NPI Number | 1669581393 |
|---|---|
| Provider Enumeration Date | 08/29/2006 |
| Last Update Date | 03/11/2022 |
| Medicare PECOS PAC ID | 8921041211 |
|---|---|
| Medicare Enrollment ID | O20050607001354 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669581393 | NPI | - | NPPES |
| 11431045 | Other | CA | CAQH ID NUMBER |
| 00A614060 | Other | CA | BLUE SHIELD PROVIDER ID # |
| 0007134338 | Other | CA | AETNA PROVIDER ID NUMBER |
| 5596075 | Other | CA | CCN/FIRST HEALTH PROVIDER |
| ZZ66803Z | Other | CA | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | A61406 (California) | Primary |
| Provider Name | Marjorie M Yong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417062167 PECOS PAC ID: 3476597956 Enrollment ID: I20050616000932 |
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