Organization
SOULPHYSIO LIFESTYLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANEESH CHAUDHRY (OWNER)
(949) 418-7956
Entity
Organization
Contact information
Practice address
17805 SKY PARK CIR STE F, IRVINE, CA 92614-6108
(949) 418-7956
Mailing address
17805 SKY PARK CIR STE F, IRVINE, CA 92614-6108
(949) 418-7956
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/20/2021
Last updated
08/27/2021
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