Organization
JWCH INSTITUTE INC
Active
Other names
JWCH Institute Inc Medical Clinic Weingart Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALVARO P BALLESTEROS (CHIEF EXECUTIVE OFFICER)
(323) 201-4516
Entity
Organization
Contact information
Practice address
522 S SAN PEDRO ST, LOS ANGELES, CA 90013-2102
(213) 622-2639
(213) 624-8738
Mailing address
5650 JILLSON ST, COMMERCE, CA 90040-1482
(323) 201-4516
(323) 215-0171
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251X00000X
Supports Brokerage Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QD0000X
Dental Clinic/Center
950001280
CA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
950001280
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70900F
—
CA
Enumeration date
05/16/2006
Last updated
06/22/2022
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