Chisan Healthcare Corp | |
8803 S 8th Ave Inglewood CA 90305 | |
(323) 347-9220 | |
Not Available |
Full Name | Chisan Healthcare Corp |
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Speciality | Clinic/Center |
Location | 8803 S 8th Ave, Inglewood, California |
Authorized Official Name and Position | Samuel Chinenye Godwin (NP) |
Authorized Official Contact | 3233479220 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Chisan Healthcare Corp 8803 S 8th Ave Inglewood CA 90305 Ph: (323) 347-9220 | Chisan Healthcare Corp 8803 S 8th Ave Inglewood CA 90305 Ph: (323) 347-9220 |
NPI Number | 1972365237 |
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Provider Enumeration Date | 01/23/2024 |
Last Update Date | 04/15/2024 |
Certification Date | 04/15/2024 |
Medicare PECOS PAC ID | 2365889664 |
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Medicare Enrollment ID | O20240322000122 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972365237 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Samuel C Godwin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699305839 PECOS PAC ID: 3274970579 Enrollment ID: I20240322000185 |
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