NPIMap

Organization Active NPI

Four Wellness Clinic Inc

  • Urgent Care Clinic/Center
  • Canoga Park, CA
National Provider Identifier
1932816295
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
FOUR WELLNESS CLINIC INC
Practice address
21300 Sherman Way Ste 3
Canoga Park, CA 91303-3672
Phone
(818) 835-9039
Fax
(818) 900-2478
NPI assigned
Nov 4, 2022
Last updated
Nov 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Authorized official

Name
Dr. Richard Park, MD
Title
Owner
Phone
(818) 835-9039

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Surgical Family Planning Clinic/Center 261QF0050X NU
Primary Care Clinic/Center 261QP2300X NU
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

21300 Sherman Way Ste 3
Canoga Park, CA 91303-3672

Mailing address

21300 Sherman Way Ste 3
Canoga Park, CA 91303-3672
Phone (818) 835-9039

National Provider Directory

National Provider Directory

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": "1667520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667520000000",
    "number": "1932816295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21300 SHERMAN WAY STE 3",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913033672",
            "telephone_number": "818-835-9039",
            "fax_number": "818-900-2478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21300 SHERMAN WAY STE 3",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913033672",
            "telephone_number": "818-835-9039",
            "fax_number": "818-900-2478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR WELLNESS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-835-9039",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canoga Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; 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.