Provider Demographics
NPI:1235500513
Name:COMMUNITY MEDICAL WELLNESS CENTERS USA
Entity Type:Organization
Organization Name:COMMUNITY MEDICAL WELLNESS CENTERS USA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-485-6274
Mailing Address - Street 1:1360 E ANAHEIM ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-5514
Mailing Address - Country:US
Mailing Address - Phone:562-270-0324
Mailing Address - Fax:562-591-0109
Practice Address - Street 1:1360 E ANAHEIM ST
Practice Address - Street 2:SUITE 101
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-5514
Practice Address - Country:US
Practice Address - Phone:562-270-0324
Practice Address - Fax:562-591-0109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-13
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)