| Wellmate Clinic | |
|
1107 Crenshaw Blvd, Los Angeles, CA 90019-3112 | |
| (323) 289-8601 | |
| (323) 289-8603 |
| Full Name | Wellmate Clinic |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1107 Crenshaw Blvd, Los Angeles, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821607268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| Provider Name | Jennifer K Champa |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144487190 PECOS PAC ID: 9335302140 Enrollment ID: I20120515000134 |
| Provider Name | Brian K Lee |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1295296598 PECOS PAC ID: 6709272560 Enrollment ID: I20220404000295 |
| Mailing Address | Practice Location Address |
|---|---|
| Wellmate Clinic 1107 Crenshaw Blvd, Los Angeles, CA 90019-3112 Ph: (323) 289-8601 | Wellmate Clinic 1107 Crenshaw Blvd, Los Angeles, CA 90019-3112 Ph: (323) 289-8601 |
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