Jwch Medical Clinic - Covenant House California | |
1325 N Western Ave Los Angeles CA 90027-5615 | |
(323) 461-3131 | |
(323) 957-7419 |
Full Name | Jwch Medical Clinic - Covenant House California |
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Speciality | Clinic/center - Community Health |
Location | 1325 N Western Ave, Los Angeles, California |
Authorized Official Name and Position | Alvaro P. Ballesteros (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 3232014516 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Jwch Medical Clinic - Covenant House California 5650 Jillson Street Commerce CA 90040-1482 Ph: (323) 201-4516 | Jwch Medical Clinic - Covenant House California 1325 N Western Ave Los Angeles CA 90027-5615 Ph: (323) 461-3131 |
NPI Number | 1528515152 |
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Provider Enumeration Date | 09/01/2016 |
Last Update Date | 09/01/2016 |
Identifier | Type | State | Issuer |
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1528515152 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QC1500X | Clinic/center - Community Health | (California) | Primary |
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