Wave Wellness Clinic Professional Corporation
NPI #1417774399 in Encinitas, California
Provider Information
- NPI Number
- 1417774399
- Entity Type
- Organization
- Organization Name
- Wave Wellness Clinic Professional Corporation
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Sep 23, 2024
- Last Updated
- Nov 20, 2024
Practice Location
- Address
- 4407 MANCHESTER AVE STE 101
- City
- Encinitas
- State
- California
- ZIP Code
- 92024-4941
- Phone
- (760) 652-6800
Authorized Official
- Name
- EMMA DORANTES
- Title
- OFFICE MANAGER
- Phone
- (760) 458-7539
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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