Healthcare Provider Details

I. General information

NPI: 1740655661
Provider Name (Legal Business Name): GATEWAYS HOSPITAL AND MENTAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2015
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 W COLLEGE ST STE 500
LOS ANGELES CA
90012-1246
US

IV. Provider business mailing address

1891 EFFIE STREET
LOS ANGELES CA
90026-1711
US

V. Phone/Fax

Practice location:
  • Phone: 323-644-2000
  • Fax:
Mailing address:
  • Phone: 323-644-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number930000058
License Number StateCA

VIII. Authorized Official

Name: PHILIP WONG
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: PSY.D
Phone: 323-644-2000