| Bhs - El Puerto Family Health Center | |
|
1334 N Avalon Blvd Wilmington CA 90744-2639 | |
| (310) 835-4009 | |
| (310) 679-2920 |
| Full Name | Bhs - El Puerto Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1334 N Avalon Blvd, Wilmington, California |
| Authorized Official Name and Position | Shirley Ann Summers (PRESIDENT/CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3106799126 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bhs - El Puerto Family Health Center 15519 Crenshaw Blvd Gardena CA 90249-4525 Ph: (310) 679-9126 | Bhs - El Puerto Family Health Center 1334 N Avalon Blvd Wilmington CA 90744-2639 Ph: (310) 835-4009 |
| NPI Number | 1023536992 |
|---|---|
| Provider Enumeration Date | 08/31/2017 |
| Last Update Date | 08/31/2017 |
| Medicare PECOS PAC ID | 8729142146 |
|---|---|
| Medicare Enrollment ID | O20180717000681 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023536992 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 550003493 (California) | Primary |
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