BROADWAY WELLNESS CENTER, INC. – NPI #1700417797
Clinic/Center

BROADWAY WELLNESS CENTER, INC. is an AHC clinic located in GLENDALE, CA. NPPES has assigned the NPI number 1700417797 to BROADWAY WELLNESS CENTER, INC. on January 29, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 5 years ago on Mar 23, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BROADWAY WELLNESS CENTER, INC. below.

NPI Profile for
BROADWAY WELLNESS CENTER, INC.

NPI Number
1700417797
Enumeration Date

(more than 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BROADWAY WELLNESS CENTER, INC.
Primary location
435 ARDEN AVE SUITE 520
GLENDALE, CA 91203
Phone: (818) 696-0091 Fax: (818) 484-2449
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
SILVA MORADI
CEO
Phone: (818) 696-0091
Updated
Certification Date
Mar 23, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.