Organization Active NPI

Luzwave Art of Healing Inc.

  • Rehabilitation Clinic/Center
  • Tustin, CA
National Provider Identifier
1174164917
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
LUZWAVE ART OF HEALING INC.
Practice address
14642 Newport Ave Ste 105
Tustin, CA 92780-6058
Phone
(949) 527-6400
Fax
(714) 486-2309
NPI assigned
Oct 2, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Linda Mack
Title
Coo
Phone
(949) 527-6400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

14642 Newport Ave Ste 105
Tustin, CA 92780-6058

Mailing address

14642 Newport Ave Ste 105
Tustin, CA 92780-6058
Phone (951) 801-5566

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584403200000",
    "number": "1174164917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14642 NEWPORT AVE STE 105",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806058",
            "telephone_number": "951-801-5566",
            "fax_number": "951-801-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14642 NEWPORT AVE STE 105",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806058",
            "telephone_number": "949-527-6400",
            "fax_number": "714-486-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUZWAVE ART OF HEALING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-02",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "949-527-6400"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.