| Wesley Health Centers - San Julian Oasis | |
|
628 San Julian St Los Angeles CA 90014-2412 | |
| (323) 201-4516 | |
| Not Available |
| Full Name | Wesley Health Centers - San Julian Oasis |
|---|---|
| Speciality | Clinic/Center |
| Location | 628 San Julian St, Los Angeles, California |
| Authorized Official Name and Position | Alvaro Prospero Ballesteros (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3232014516 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wesley Health Centers - San Julian Oasis 5650 Jillson St Commerce CA 90040-1482 Ph: (323) 201-4516 | Wesley Health Centers - San Julian Oasis 628 San Julian St Los Angeles CA 90014-2412 Ph: (323) 201-4516 |
| NPI Number | 1710610324 |
|---|---|
| Provider Enumeration Date | 07/01/2022 |
| Last Update Date | 12/05/2022 |
| Medicare PECOS PAC ID | 1850394123 |
|---|---|
| Medicare Enrollment ID | O20230131002233 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710610324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
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