NPIMap

Organization Active NPI

Inner Gate Wellness

  • Acupuncturist
  • Culver City, CA
National Provider Identifier
1508453119
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Legal business name
INNER GATE WELLNESS
Doing business as
Inner Gate Wellness
Practice address
12061A Jefferson Blvd Apt C
Culver City, CA 90230-6219
Phone
(424) 280-6730
NPI assigned
Dec 29, 2020
Last updated
Dec 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Authorized official

Name
Jennifer Ryan, LACNPI 1811376692
Title
Owner
Phone
(424) 280-6730

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X NU Primary

Addresses

Primary practice location

12061A Jefferson Blvd Apt C
Culver City, CA 90230-6219

Mailing address

12061A Jefferson Blvd Apt C
Culver City, CA 90230-6219
Phone (424) 280-6730

Other names 1

  • Inner Gate Wellness Doing business as

National Provider Directory

National Provider Directory

Locations

12061A Jefferson Blvd
Apt C
Culver City, CA 90230
Phone (424) 280-6730

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.

NPI Registry JSON

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609200000000",
    "number": "1508453119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12061A JEFFERSON BLVD APT C",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306219",
            "telephone_number": "424-280-6730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12061A JEFFERSON BLVD APT C",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306219",
            "telephone_number": "424-280-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER GATE WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "424-280-6730",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inner Gate Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.