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Organization
WESTERN HEALTH COMMUNITY CLINIC
Active
Organization
WESTERN HEALTH COMMUNITY CLINIC
Active
Other names
SMARTs
Organization subpart
No
Provider details
NPI number
Authorized official
RICK Q WILSON PH.D. (PRESIDENT)
(310) 534-5590
Entity
Organization
Contact information
Practice address
1647 W ANAHEIM ST, HARBOR CITY, CA 90710-3213
(310) 534-5590
(310) 534-5591
Mailing address
PO BOX 6009, SAN PEDRO, CA 90734-6009
(310) 938-4961
(310) 534-5591
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G42264
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0548686
CLIA
CA
Enumeration date
12/05/2005
Last updated
08/08/2023
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