Organization
EVERGREEN WELLNESS CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN KIM-WAGNER ACUPUNCTURIST (PRESIDENT)
(323) 665-1985
Entity
Organization
Contact information
Practice address
2950 LOS FELIZ BLVD, 203, LOS ANGELES, CA 90039-1532
(323) 665-1985
Mailing address
2950 LOS FELIZ BLVD, 203, LOS ANGELES, CA 90039-1532
(323) 665-1985
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
AC9278
CA
Other
Enumeration date
01/29/2008
Last updated
11/01/2016
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