| Prime Wellness Community Health Center | |
|
8610 S Sepulveda Blvd Ste 104 Los Angeles CA 90045-4009 | |
| (310) 659-7867 | |
| (310) 878-2118 |
| Full Name | Prime Wellness Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 8610 S Sepulveda Blvd Ste 104, Los Angeles, California |
| Authorized Official Name and Position | Denys Slesarenko (CEO) |
| Authorized Official Contact | 3106597867 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Wellness Community Health Center 8610 S Sepulveda Blvd Ste 104 Los Angeles CA 90045-4009 Ph: (310) 659-7867 | Prime Wellness Community Health Center 8610 S Sepulveda Blvd Ste 104 Los Angeles CA 90045-4009 Ph: (310) 659-7867 |
| NPI Number | 1083251532 |
|---|---|
| Provider Enumeration Date | 12/03/2019 |
| Last Update Date | 06/09/2021 |
| Medicare PECOS PAC ID | 3375944150 |
|---|---|
| Medicare Enrollment ID | O20210630002908 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083251532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
| Provider Name | Nicolette L Ballou |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457420077 PECOS PAC ID: 2062814775 Enrollment ID: I20210716001067 |
Joseph I Kang Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3755 Beverly Blvd, Ste 301, Los Angeles, CA 90004 Phone: 323-664-7777 | |
Clinica Virgen De Guadalupe Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 985 W Vernon Ave, Los Angeles, CA 90037 Phone: 323-234-6300 | |
Ssg San Pedro Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5811 S San Pedro St, Los Angeles, CA 90011 Phone: 213-553-1800 | |
John L Sherman Md Amc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8635 W 3rd St Ste 485w, Los Angeles, CA 90048 Phone: 310-855-8081 Fax: 310-855-0438 | |
Altamed Medical Group Eapc Prop 99 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 Citadel Dr, Ste 490, Los Angeles, CA 90040 Phone: 323-725-8751 Fax: 323-889-7399 | |
Altamed Health Services Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5425 Pomona Blvd, Los Angeles, CA 90022 Phone: 323-832-7527 Fax: 323-832-7599 | |
Apla Health & Wellness - David Geffen Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 611 S Kingsley Dr, Los Angeles, CA 90005 Phone: 213-201-1623 Fax: 213-201-1595 |