Organization
MINDFUL WEIGHT LOSS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIVEK GUPTA MD (PRESIDENT)
(951) 306-5448
Entity
Organization
Contact information
Practice address
510 N PROSPECT AVE STE 301, REDONDO BEACH, CA 90277-3030
(310) 997-0141
Mailing address
202 S LUCIA AVE UNIT B, REDONDO BEACH, CA 90277-3511
(951) 306-5448
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/11/2020
Last updated
04/11/2020
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