Organization
FOUR WELLNESS CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD PARK MD (OWNER)
(818) 835-9039
Entity
Organization
Contact information
Practice address
21300 SHERMAN WAY STE 3, CANOGA PARK, CA 91303-3672
(818) 835-9039
(818) 900-2478
Mailing address
21300 SHERMAN WAY STE 3, CANOGA PARK, CA 91303-3672
(818) 835-9039
(818) 900-2478
Taxonomy
Speciality
Code
Description
License number
State
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/04/2022
Last updated
11/04/2022
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