Organization
MID-WILSHIRE HEALTH CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEOUNG HIE LEE (PRESIDENT)
(323) 934-5660
Entity
Organization
Contact information
Practice address
676 S BONNIE BRAE ST, LOS ANGELES, CA 90057-3710
(213) 483-9921
(213) 483-3606
Mailing address
1101 CRENSHAW BLVD, LOS ANGELES, CA 90019-3112
(323) 934-5660
(323) 934-0852
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
970000071
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT06174J
—
CA
Enumeration date
11/16/2006
Last updated
10/15/2013
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