Organization
WILMINGTON COMMUNITY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERONICA RODARTE (REVENUE CYCLE MANAGER)
(310) 714-8521
Entity
Organization
Contact information
Practice address
1009 N AVALON BLVD, WILMINGTON, CA 90744-4505
(310) 549-5760
(310) 549-2277
Mailing address
1009 N AVALON BLVD, WILMINGTON, CA 90744-4505
(310) 549-5760
(310) 549-1453
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932194586
—
CA
Enumeration date
09/20/2005
Last updated
02/24/2026
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