| Banj Health Center, Inc. | |
|
201 N Central Ave Compton CA 90220-1425 | |
| (310) 635-7123 | |
| (310) 635-0535 |
| Full Name | Banj Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 201 N Central Ave, Compton, California |
| Authorized Official Name and Position | Marie N Lamothe (ADMINISTRATOR) |
| Authorized Official Contact | 5626394843 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Banj Health Center, Inc. 201 N Central Ave Compton CA 90220-1425 Ph: (310) 635-7123 | Banj Health Center, Inc. 201 N Central Ave Compton CA 90220-1425 Ph: (310) 635-7123 |
| NPI Number | 1518036565 |
|---|---|
| Provider Enumeration Date | 11/06/2006 |
| Last Update Date | 09/22/2016 |
| Medicare PECOS PAC ID | 6901855444 |
|---|---|
| Medicare Enrollment ID | O20050121000469 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518036565 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 960001116 (California) | Primary |
| Provider Name | Violeta Vicencio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679699193 PECOS PAC ID: 4981598257 Enrollment ID: I20040209001199 |
| Provider Name | Mohamad B Kadri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538192166 PECOS PAC ID: 2567419708 Enrollment ID: I20050520000823 |
| Provider Name | Hoang-chuong Vu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922135086 PECOS PAC ID: 7113026683 Enrollment ID: I20070625000225 |
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