| San Judas Community Health Center, Inc | |
|
2972 Wilshire Blvd Los Angeles CA 90010-1101 | |
| (213) 484-0000 | |
| (213) 387-0011 |
| Full Name | San Judas Community Health Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2972 Wilshire Blvd, Los Angeles, California |
| Authorized Official Name and Position | Nejat Rostami (CEO) |
| Authorized Official Contact | 3107804674 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| San Judas Community Health Center, Inc 1080 N Western Ave Los Angeles CA 90029-2310 Ph: (213) 484-0000 | San Judas Community Health Center, Inc 2972 Wilshire Blvd Los Angeles CA 90010-1101 Ph: (213) 484-0000 |
| NPI Number | 1396235883 |
|---|---|
| Provider Enumeration Date | 05/10/2018 |
| Last Update Date | 05/10/2018 |
| Medicare PECOS PAC ID | 2365788999 |
|---|---|
| Medicare Enrollment ID | O20220125002521 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396235883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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