Organization
WELLNESS HEALTH MEDICAL PROVIDER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BOSHARDY (VP OF LEGAL)
(773) 814-3028
Entity
Organization
Contact information
Practice address
1 LAURA LN, EAST NORTHPORT, NY 11731-4700
(949) 325-7001
Mailing address
17981 SKY PARK CIR, BLDG 39, STE BC, IRVINE, CA 92614-6309
(949) 325-7001
(949) 309-2797
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/03/2022
Last updated
11/03/2022
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