Provider Demographics
NPI:1194474288
Name:STATIC HEALTH AND WELLNESS INC A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:STATIC HEALTH AND WELLNESS INC A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SAVITA
Authorized Official - Middle Name:
Authorized Official - Last Name:KANJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-890-8001
Mailing Address - Street 1:8300 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-4311
Mailing Address - Country:US
Mailing Address - Phone:323-653-3344
Mailing Address - Fax:323-653-5853
Practice Address - Street 1:8300 W 3RD ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4311
Practice Address - Country:US
Practice Address - Phone:323-653-3344
Practice Address - Fax:323-653-5853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-23
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty