Active NPI
Mega Wellness Clinic Nursing Practitioner Inc
Doing business as wellnessclinic
- Family Nurse Practitioner
- Brea, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 18049
- Legal business name
- MEGA WELLNESS CLINIC NURSING PRACTITIONER INC
- Doing business as
- wellnessclinic
- Practice address
- 432 S Brea Blvd
Brea, CA 92821-5301 - Phone
- (714) 784-6767
- Fax
- (714) 784-6757
- NPI assigned
- Jan 9, 2018
- Last updated
- Dec 11, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Ae Rah Kang, NURSE PRACTITIONER
- Title
- NP
- Phone
- (714) 784-6767
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 18049 | CA | Primary |
| Internal Medicine Physician | 207R00000X | A4078 | CA |
Addresses
Primary practice location
432 S Brea Blvd
Brea, CA 92821-5301
Mailing address
432 S Brea Blvd
Brea, CA 92821-5301
Phone (714) 784-6767
Other names 1
- wellnessclinic
National Provider Directory
National Provider DirectoryLocations
432 S Brea Blvd
Brea, CA 92821
Phone (714) 784-6767
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Brea, CA
- NPI 1336396035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515456000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1544486400000",
"number": "1497262695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "432 S BREA BLVD",
"city": "BREA",
"state": "CA",
"postal_code": "928215301",
"telephone_number": "714-784-6767",
"fax_number": "714-784-6757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "432 S BREA BLVD",
"city": "BREA",
"state": "CA",
"postal_code": "928215301",
"telephone_number": "714-784-6767",
"fax_number": "714-784-6757"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEGA WELLNESS CLINIC NURSING PRACTITIONER INC",
"organizational_subpart": "NO",
"enumeration_date": "2018-01-09",
"last_updated": "2018-12-11",
"status": "A",
"authorized_official_last_name": "KANG",
"authorized_official_first_name": "AE RAH",
"authorized_official_title_or_position": "NP",
"authorized_official_telephone_number": "714-784-6767",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "NURSE PRACTITIONER"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "18049",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A4078",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "wellnessclinic",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Brea, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.