Healthcare Provider Details

I. General information

NPI: 1477649119
Provider Name (Legal Business Name): WATTS HEALTHCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 COMPTON AVENUE
LOS ANGELES CA
90002
US

IV. Provider business mailing address

10300 COMPTON AVE
LOS ANGELES CA
90002-3628
US

V. Phone/Fax

Practice location:
  • Phone: 323-357-6684
  • Fax:
Mailing address:
  • Phone: 323-357-6684
  • Fax: 323-563-6378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: OLUSHEYI LAWOYIN
Title or Position: COO
Credential:
Phone: 323-564-4331