Well Medical, a Professional Corporation
NPI #1699123737 in Santa Monica, California
Provider Information
- NPI Number
- 1699123737
- Entity Type
- Organization
- Organization Name
- Well Medical, a Professional Corporation
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- May 31, 2016
- Last Updated
- Mar 8, 2021
Practice Location
- Address
- 929 COLORADO AVE
- City
- Santa Monica
- State
- California
- ZIP Code
- 90401-2716
- Phone
- (424) 221-5012
Authorized Official
- Name
- ILDAR FAZULYANOV
- Title
- CHIEF OPERATING OFFICER
- Phone
- (310) 384-0970
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
| Nurse Practitioner |
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