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Organization
WELLCARE MEDICAL CLINIC INC
Active
Organization
WELLCARE MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY CHARLES MD (OFFICIER)
(714) 847-3322
Entity
Organization
Contact information
Practice address
2990 E PACIFIC COAST HWY, LONG BEACH, CA 90804-1632
(714) 847-3322
Mailing address
2990 E PACIFIC COAST HWY, LONG BEACH, CA 90804-1632
(714) 847-3322
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A46552
CA
Other
Enumeration date
05/22/2013
Last updated
12/03/2013
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