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Organization
MAGNOLIA WELLNESS INC.
Active
Organization
MAGNOLIA WELLNESS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAILI JI SHUMILAK DO (PRESIDENT)
(858) 956-0514
Entity
Organization
Contact information
Practice address
4295 GESNER ST STE 3F, SAN DIEGO, CA 92117-6667
(858) 956-0514
Mailing address
3365 29TH STREET, 1/2, SAN DIEGO, CA 92104
(619) 887-0987
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/29/2023
Last updated
06/27/2023
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