Organization
ADVANCED WELLNESS WEST VALLEY MEDICAL GROUP INC
Active
Organization
ADVANCED WELLNESS WEST VALLEY MEDICAL GROUP INC
Active
Other names
Advanced Wellness Medical
Organization subpart
No
Provider details
NPI number
Authorized official
ALLEN L LAWRENCE (OWNER)
(310) 879-9266
Entity
Organization
Contact information
Practice address
4116 W MAGNOLIA BLVD STE 100, BURBANK, CA 91505-2706
(310) 879-9266
(818) 279-0787
Mailing address
18653 VENTURA BLVD # 384, TARZANA, CA 91356-4103
(310) 879-9266
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/04/2020
Last updated
01/24/2024
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