NPIMap

Organization Active NPI

Wonderful Center for Health Innovation Inc

Doing business as Wonderful Wellness Center - Lost Hills

  • Primary Care Clinic/Center
  • Lost Hills, CA
National Provider Identifier
1750752804
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 - Lost Hills
Practice address
13646 Highway 33
Lost Hills, CA 93249-9719
Phone
(661) 797-6606
Fax
(661) 797-6667
NPI assigned
Oct 15, 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

13646 Highway 33
Lost Hills, CA 93249-9719

Mailing address

13646 Highway 33
Lost Hills, CA 93249-9719
Phone (661) 797-6606

Other names 1

  • Wonderful Wellness Center - Lost Hills Doing business as

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.

NPI Registry JSON

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567468800000",
    "number": "1750752804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13646 HIGHWAY 33",
            "city": "LOST HILLS",
            "state": "CA",
            "postal_code": "932499719",
            "telephone_number": "661-797-6606",
            "fax_number": "661-797-6667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13646 HIGHWAY 33",
            "city": "LOST HILLS",
            "state": "CA",
            "postal_code": "932499719",
            "telephone_number": "661-797-6606",
            "fax_number": "661-797-6667"
        }
    ],
    "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": "2015-10-15",
        "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 - Lost Hills",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wonderful Wellness Center - Lost Hills",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lost Hills, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.