Organization
LOS ANGELES COUNTY - WIDNEY MTU
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WESLEY L FORD M.A., M.P.H. (DIRECTOR)
(626) 569-6001
Entity
Organization
Contact information
Practice address
2302 S GRAMERCY PL, LOS ANGELES, CA 90018-1323
(323) 731-8442
(323) 733-2486
Mailing address
9320 TELSTAR AVE STE 226, EL MONTE, CA 91731-2816
(800) 288-4584
(626) 569-6480
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CCS00135F
—
CA
Enumeration date
12/18/2007
Last updated
12/18/2007
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