Provider Demographics
NPI:1891135562
Name:THE WELLS COMPREHENSIVE CARE SYSTEM & CLINICS, INC.
Entity Type:Organization
Organization Name:THE WELLS COMPREHENSIVE CARE SYSTEM & CLINICS, INC.
Other - Org Name:WELLS CCS CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHUANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-427-1490
Mailing Address - Street 1:PO BOX 989
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91802-0989
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:207 S SANTA ANITA AVE STE G18
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1147
Practice Address - Country:US
Practice Address - Phone:626-427-1490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-26
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty