# WESTERN HEALTH COMMUNITY CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SMARTs
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134103930
- **Authorized official:** RICK Q WILSON PH.D. (PRESIDENT)
- **Authorized official phone:** (310) 534-5590

## Contact information

- **Practice address:** 1647 W ANAHEIM ST, HARBOR CITY, CA 90710-3213
- **Practice address phone:** (310) 534-5590
- **Practice address fax:** (310) 534-5591
- **Mailing address:** PO BOX 6009, SAN PEDRO, CA 90734-6009
- **Mailing address phone:** (310) 938-4961
- **Mailing address fax:** (310) 534-5591

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | G42264 | CA | Yes |

## Other

- **Enumeration date:** 12/05/2005
- **Last updated:** 08/08/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 05D0548686 | CLIA | CA |