# ELITE VITALITY WELLNESS, NURSING PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003705211
- **Authorized official:** ERICA VEGA (CEO & PRESIDENT)
- **Authorized official phone:** (310) 387-2410

## Contact information

- **Practice address:** 3231 W 132ND ST, HAWTHORNE, CA 90250-5503
- **Practice address phone:** (310) 387-2410
- **Mailing address:** 3231 W 132ND ST, HAWTHORNE, CA 90250-5503

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/01/2025
- **Last updated:** 07/01/2025