NPIMap

Organization Active NPI

Wonderful Center for Health Innovation Inc

Doing business as Wonderful Wellness Center - Delano

  • Primary Care Clinic/Center
  • Delano, CA
National Provider Identifier
1720454192
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
C140498 Issued in CA
Legal business name
WONDERFUL CENTER FOR HEALTH INNOVATION INC
Doing business as
Wonderful Wellness Center - Delano
Practice address
1701 S Lexington St
Delano, CA 93215-9200
Phone
(661) 720-2660
Fax
(661) 720-2661
NPI assigned
Aug 19, 2015
Last updated
Sep 3, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
WONDERFUL CENTER FOR HEALTH INNOVATION INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Authorized official

Name
Dr. Larry Wolk, MD MSPH
Title
Chief Medical Officer
Phone
(661) 720-2660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X C140498 CA Primary

Addresses

Primary practice location

1701 S Lexington St
Delano, CA 93215-9200

Mailing address

1701 S Lexington St
Delano, CA 93215-9200
Phone (661) 720-2660

Other names 1

  • Wonderful Wellness Center - Delano Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2104014Wonderful Center1701 S Lexington St, Delano, CA 93215Certificate of waiverApr 1, 2028

National Provider Directory

National Provider Directory
Tax ID family
Wonderful Center for Health Innovation Inc6 organizations share this tax ID, including this one
Part of
Wonderful Center for Health Innovation Inc

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1701 S Lexington St
Delano, CA 93215
Phone (661) 720-2660

Practitioners & affiliated clinicians

Practitioners 3

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": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567468800000",
    "number": "1720454192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 S LEXINGTON ST",
            "city": "DELANO",
            "state": "CA",
            "postal_code": "932159200",
            "telephone_number": "661-720-2660",
            "fax_number": "661-720-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 S LEXINGTON ST",
            "city": "DELANO",
            "state": "CA",
            "postal_code": "932159200",
            "telephone_number": "661-720-2660",
            "fax_number": "661-720-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WONDERFUL CENTER FOR HEALTH INNOVATION INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WONDERFUL CENTER FOR HEALTH INNOVATION INC",
        "enumeration_date": "2015-08-19",
        "last_updated": "2019-09-03",
        "status": "A",
        "authorized_official_last_name": "WOLK",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "661-720-2660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD MSPH"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "C140498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wonderful Wellness Center - Delano",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wonderful Wellness Center - Delano",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Delano, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.