Provider Demographics
NPI:1093323933
Name:BAWJ MEDICAL SERVICES
Entity Type:Organization
Organization Name:BAWJ MEDICAL SERVICES
Other - Org Name:PERRIS COMMUNITY FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:909-228-4221
Mailing Address - Street 1:524 W 4TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-2016
Mailing Address - Country:US
Mailing Address - Phone:951-355-0030
Mailing Address - Fax:951-420-5005
Practice Address - Street 1:524 W 4TH ST STE B
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-2016
Practice Address - Country:US
Practice Address - Phone:951-355-0030
Practice Address - Fax:951-420-5005
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAWJ MEDICAL SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-16
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty