EBENEZER WELLNESS CENTER INC. NPI 1114339272

NPI Information

NPI: 1114339272
Provider Name: EBENEZER WELLNESS CENTER, INC.
Classification: General Practice - 208D00000X
Entity Type: Organization
Address: 16261 LAGUNA CANYON RD
SUITE 100
IRVINE, CA
ZIP 92618
Phone: (714) 636-3886

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NPI Details

EBENEZER WELLNESS CENTER, INC. is a general practice in Irvine, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee EBENEZER WELLNESS CENTER, INC. NPI is 1114339272. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

16261 LAGUNA CANYON RD
SUITE 100
IRVINE, CA
ZIP 92618-608
Phone: (714) 636-3886

The provider's authorized official is Junghee Kim .
The authorized official title is Vice President and has the following contact phone number (714) 618-3942.

The enumeration date for this NPI number is 5/23/2014 and was last updated on 5/23/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		A86714	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	A86714	OTHER	CALIFORNIA	CA MEDICAL BOARD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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