Organization
JWCH INSTITUTE, INC.
Active
Organization
JWCH INSTITUTE, INC.
Active
Other names
JWCH PATH Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALVARO PROSPERO BALLESTEROS (CHIEF EXECUTIVE OFFICER)
(323) 201-4516
Entity
Organization
Contact information
Practice address
340 N MADISON AVE, LOS ANGELES, CA 90004-3504
(323) 201-4516
Mailing address
5650 JILLSON ST, COMMERCE, CA 90040-1482
(323) 201-4516
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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