Organization · NPI-2

Inland Empire Wellness Medical Group INC

Internal Medicine · Indio, CA

NPI number1285484907

StatusActive

Last updated in NPPESMar 25, 2024

Details

NPI: 1285484907
Entity type: Organization (NPI-2)
Legal business name: Inland Empire Wellness Medical Group INC
Organization subpart: No
Enumeration date: Mar 25, 2024
Certification date: Mar 25, 2024
Last updated: Mar 25, 2024

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207R00000X	Internal Medicine	–	–	Yes
103G00000X	Clinical Neuropsychologist	–	–
103T00000X	Psychologist	–	–
111N00000X	Chiropractor	–	–
111NR0200X	Chiropractor, Radiology	–	–
171100000X	Acupuncturist	–	–
2085R0202X	Radiology, Diagnostic Radiology	–	–
225X00000X	Occupational Therapist	–	–
246ZE0600X	Specialist/Technologist, Other, Electroneurodiagnostic	–	–

Practice location

81557 Doctor Carreon Blvd Ste B2
Indio, CA 92201-5562

Phone 760-647-0647 · Fax 760-600-9192

Mailing address

81557 Doctor Carreon Blvd Ste B2
Indio, CA 92201-5562

Phone 760-647-0647 · Fax 760-600-9192

Authorized official

Roya Khodaie
Owner
7034777572

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