Organization
JWCH INSTITUTE INC.
Active
Organization
JWCH INSTITUTE INC.
Active
Other names
JWCH PATH Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ALVARO PROSPERO BALLESTEROS (CHIEF EXECUTIVE OFFICER)
(323) 201-4516
Entity
Organization
Contact information
Practice address
320 N MADISON AVE, LOS ANGELES, CA 90004-3779
(323) 644-2252
Mailing address
5650 JILLSON ST, COMMERCE, CA 90040-1482
(323) 201-4516
(323) 215-0170
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
05/21/2021
Last updated
05/21/2021
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