| Wilmington Subcenter | |
|
1325 Broad Ave Wilmington CA 90744-2604 | |
| (562) 804-8101 | |
| Not Available |
| Full Name | Wilmington Subcenter |
|---|---|
| Speciality | Clinic/center |
| Location | 1325 Broad Ave, Wilmington, California |
| Authorized Official Name and Position | Miguel Ortiz-marroquin (INTERIM CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3102222104 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilmington Subcenter 1325 Broad Ave Wilmington CA 90744-2604 Ph: (562) 804-8101 | Wilmington Subcenter 1325 Broad Ave Wilmington CA 90744-2604 Ph: (562) 804-8101 |
| NPI Number | 1225044662 |
|---|---|
| Provider Enumeration Date | 07/31/2006 |
| Last Update Date | 12/27/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225044662 | NPI | - | NPPES |
| HAP16026F | Other | CA | WIL HC FAMILY PACT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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