Jwch Institute, Inc | |
1670 E 120 Street West Support Bldg #14 Fl 2 Los Angeles CA 90059-3026 | |
(323) 201-4516 | |
Not Available |
Full Name | Jwch Institute, Inc |
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Speciality | Clinic/Center |
Location | 1670 E 120 Street, Los Angeles, California |
Authorized Official Name and Position | Al Ballersteros (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 |
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Jwch Institute, Inc 5650 Jillson St Commerce CA 90040-1482 Ph: (323) 201-4516 | Jwch Institute, Inc 1670 E 120 Street West Support Bldg #14 Fl 2 Los Angeles CA 90059-3026 Ph: (323) 201-4516 |
NPI Number | 1811548712 |
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Provider Enumeration Date | 09/23/2019 |
Last Update Date | 09/23/2019 |
Medicare PECOS PAC ID | 1850394123 |
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Medicare Enrollment ID | O20200608002552 |
Identifier | Type | State | Issuer |
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1811548712 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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