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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