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Advanced Wellness West Valley Medical Group Inc

Organization Active NPI Multi-Specialty Clinic/Center · Burbank, CA

NPI 1972124675 · NPPES record last updated Jan 24, 2024

Key facts

NPI
1972124675
Entity type
Organization (NPI type 2)
Primary specialty
Multi-Specialty Clinic/Center 261QM1300X
Legal business name
ADVANCED WELLNESS WEST VALLEY MEDICAL GROUP INC
Practice address
4116 W Magnolia Blvd Ste 100
Burbank, CA 91505-2706
Phone
(310) 879-9266
Fax
(818) 279-0787
NPI assigned
May 4, 2020
Organization subpart
No

Authorized official

Name
Allen L Lawrence
Title
Owner
Phone
(310) 879-9266

National Provider Directory

Locations

4116 W Magnolia Blvd
Ste 100
Burbank, CA 91505
Phone (310) 879-9266

18653 Ventura Blvd
Tarzana, CA 91356
Phone (818) 212-8904

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2083P0500X
Multi-Specialty Clinic/Center 261QM1300X Yes

Addresses

Primary practice location

4116 W Magnolia Blvd Ste 100
Burbank, CA 91505-2706

Mailing address

18653 Ventura Blvd # 384
Tarzana, CA 91356-4103
Phone (310) 879-9266

Other names

  • Advanced Wellness Medical Doing business as

Other providers in Burbank, CA

All providers in Burbank, CA · Multi-Specialty Clinic/Center in California

Sources for this page

Verify at the official NPI Registry.