Organization
WATTS HEALTHCARE CORPORATION
Active
Parent organization
WATTS HEALTHCARE CORPORATION
Other names
Locke Wellness Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
WATTS HEALTHCARE CORPORATION
Authorized official
DAVID BRUMLAGE (ASSISTANT CONTROLLER)
(323) 564-4331
Entity
Organization
Contact information
Practice address
316 E 111TH ST, LOS ANGELES, CA 90061-3004
(323) 568-3093
Mailing address
10300 COMPTON AVE, LOS ANGELES, CA 90002-3628
(323) 357-6680
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
550002583
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104246362
—
CA
05
—
1477649119
—
CA
Enumeration date
04/25/2014
Last updated
05/23/2023
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