Integrated Wellness Group

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT30229 Issued in CA

Legal business name

INTEGRATED WELLNESS GROUP

Practice address

16055 Ventura Blvd
440
Encino, CA 91436-2601

Phone

(818) 788-2050

Fax

(818) 788-2058

NPI assigned

May 13, 2014

Last updated

May 13, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sean Shaw

Title

Administrator

Phone

(818) 788-2050

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399939200000",
    "number": "1265843213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16055 VENTURA BLVD",
            "address_2": "440",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362601",
            "telephone_number": "818-788-2050",
            "fax_number": "818-788-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16055 VENTURA BLVD",
            "address_2": "440",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362601",
            "telephone_number": "818-788-2050",
            "fax_number": "818-788-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED WELLNESS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-13",
        "last_updated": "2014-05-13",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-788-2050"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT30229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inner Light Recovery LLC
• Insight Health Corp (INSIGHT IMAGING - Encino)
• Insight Health Corp (Open MRI of Encino)
• Institute for Effective Behavioral Interventions
• Integra Surgery Center LLC
• Interventional Pain Management (Interventional Pain Management Medical Group Inc.)
• Invivo Natural Health Center
• Ipeer Solutions Inc. (iPeer Sleep Laboratories)
• Iraj Ebrami D.D.S. Inc.
• Irena Starchenko DDS, Inc

• Physical Therapist in Encino, CA
• Providers in Encino, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; 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.