| Wellness Center At Jefferson High School | |
|
3410 S. Hooper Ave. Los Angeles CA 90011-2161 | |
| (323) 908-4200 | |
| (323) 908-4256 |
| Full Name | Wellness Center At Jefferson High School |
|---|---|
| Speciality | Clinic/Center |
| Location | 3410 S. Hooper Ave., Los Angeles, California |
| Authorized Official Name and Position | Richard A Veloz (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3239084247 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness Center At Jefferson High School 4425 S Central Ave Los Angeles CA 90011-3629 Ph: (323) 908-4200 | Wellness Center At Jefferson High School 3410 S. Hooper Ave. Los Angeles CA 90011-2161 Ph: (323) 908-4200 |
| NPI Number | 1588908305 |
|---|---|
| Provider Enumeration Date | 11/16/2012 |
| Last Update Date | 07/02/2021 |
| Medicare PECOS PAC ID | 5597675041 |
|---|---|
| Medicare Enrollment ID | O20210719002659 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588908305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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