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Yong At Heart Total Wellness Medical Corporation
Clinic/Center in Encino, California
NPI 1669581393

Yong At Heart Total Wellness Medical Corporation is a Clinic/Center based in Encino, CA. Yong At Heart Total Wellness Medical Corporation practices in Encino, CA. The NPI Number for Yong At Heart Total Wellness Medical Corporation is 1669581393 and holds a License No. A61406 (California).

The current practice location address for Yong At Heart Total Wellness Medical Corporation is 16838 Clark St Ste C, Encino, CA and can be reached out via phone at 818-789-0203 and via fax at 818-789-0208.

Location: 16838 Clark St Ste C, Encino, CA, 91436-1900
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1669581393
Provider Name
Yong At Heart Total Wellness Medical Corporation
Credential
Provider Entity Type
Organization
Address
16838 Clark St Ste C, Encino, CA, 91436-1900
Phone Number
818-789-0203
Fax Number
818-789-0208
Provider Enumeration Date
08/29/2006
Last Update Date
02/15/2025
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Provider's Legacy Identifiers
Identifier Type State Issuer
11431045 01 CA CAQH ID NUMBER
00A614060 01 CA BLUE SHIELD PROVIDER ID #
0007134338 01 CA AETNA PROVIDER ID NUMBER
5596075 01 CA CCN/FIRST HEALTH PROVIDER
ZZ66803Z 01 CA BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
16838 Clark St Ste C
City
Encino
State
California
Zip
91436-1066
Phone Number
818-789-0203
Fax Number
818-789-0208
person
Provider Business Mailing Address Details
Address
16838 Clark St Ste C
City
Encino
State
California
Zip
91436-1066
Phone Number
818-789-0203
Fax Number
818-789-0208
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
A61406 (California)
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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