| Wilmington Community Clinic | |
|
1009 N Avalon Blvd Wilmington CA 90744-4505 | |
| (310) 549-5760 | |
| (310) 549-2277 |
| Full Name | Wilmington Community Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1009 N Avalon Blvd, Wilmington, California |
| Authorized Official Name and Position | Dolores Bonilla (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3105495760 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilmington Community Clinic 1009 N Avalon Blvd Wilmington CA 90744-4505 Ph: (310) 549-5760 | Wilmington Community Clinic 1009 N Avalon Blvd Wilmington CA 90744-4505 Ph: (310) 549-5760 |
| NPI Number | 1932194586 |
|---|---|
| Provider Enumeration Date | 09/20/2005 |
| Last Update Date | 08/03/2022 |
| Medicare PECOS PAC ID | 2567506504 |
|---|---|
| Medicare Enrollment ID | O20100215000535 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932194586 | NPI | - | NPPES |
| 1932194586 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Wayman Merrill, Iii |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225186190 PECOS PAC ID: 2264594563 Enrollment ID: I20081220000137 |
| Provider Name | Susan A Ballagh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245201201 PECOS PAC ID: 3072673532 Enrollment ID: I20090305000706 |
| Provider Name | Marco Antonio Garcia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518075209 PECOS PAC ID: 8123928850 Enrollment ID: I20160202002226 |
Bhs - El Puerto Family Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1334 N Avalon Blvd, Wilmington, CA 90744 Phone: 310-835-4009 Fax: 310-679-2920 | |
Harbor Comprehensive Health Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 803 Figueroa St, Wilmington, CA 90744 Phone: 310-830-0863 Fax: 310-830-0863 | |
Wilmington Community Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1122 W Anaheim St, Wilmington, CA 90744 Phone: 310-549-5760 | |
Wilmington Subcenter Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1325 Broad Ave, Wilmington, CA 90744 Phone: 562-804-8101 | |
Nationwide Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1322 N Avalon Blvd, Wilmington, CA 90744 Phone: 310-513-1300 Fax: 310-513-1311 | |
United Physician Multispecialty Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1037 E Pacific Coast Hwy, Wilmington, CA 90744 Phone: 310-549-6950 | |
Shalom Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1721 N Wilmington Blvd, Wilmington, CA 90744 Phone: 310-835-1414 Fax: 310-835-4050 |