Provider Demographics
NPI:1639570229
Name:CAREWELL MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:CAREWELL MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KWANGMYUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:213-259-9556
Mailing Address - Street 1:1906 OCEANSIDE BLVD
Mailing Address - Street 2:SUITE S
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-4484
Mailing Address - Country:US
Mailing Address - Phone:213-259-9556
Mailing Address - Fax:888-355-6203
Practice Address - Street 1:4501 S ALAMEDA ST
Practice Address - Street 2:#D-3
Practice Address - City:VERNON
Practice Address - State:CA
Practice Address - Zip Code:90058-2010
Practice Address - Country:US
Practice Address - Phone:213-259-9556
Practice Address - Fax:888-355-6203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-15
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10231171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty