Organization
ST. JOHN'S WELL CHILD AND FAMILY CENTER, INC.
Active
Other names
St. John's Well Child and Family Center
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES J. MANGIA (PRESIDENT AND CEO)
(323) 541-1600
Entity
Organization
Contact information
Practice address
400 W WASHINGTON BLVD BLDG E-102, LOS ANGELES, CA 90015-4108
(323) 541-1600
(323) 541-1661
Mailing address
808 W 58TH ST, LOS ANGELES, CA 90037-3632
(323) 541-1600
(323) 541-1661
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649680588
—
CA
Enumeration date
04/30/2014
Last updated
04/25/2017
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