# AERIS MOBILE WELLNESS LLC

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

## Provider details

- **NPI number:** 1740178953
- **Authorized official:** ELENA GONZALEZ CPT 1 (OWNER)
- **Authorized official phone:** (818) 919-1666

## Contact information

- **Practice address:** 15060 VICTORY BLVD UNIT 204, VAN NUYS, CA 91411-1829
- **Practice address phone:** (805) 552-6753
- **Mailing address:** 6221 VAN NUYS BLVD \# 659, VAN NUYS, CA 91401-2710
- **Mailing address phone:** (805) 552-6753

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | — | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 06/25/2025
- **Last updated:** 06/30/2025