Provider Demographics
NPI:1891048955
Name:WELCH, JAMES LAWRENCE
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LAWRENCE
Last Name:WELCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 E LIME AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-2982
Mailing Address - Country:US
Mailing Address - Phone:626-353-1696
Mailing Address - Fax:
Practice Address - Street 1:513 E LIME AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-2982
Practice Address - Country:US
Practice Address - Phone:626-353-1696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator