Healthcare Provider Details

I. General information

NPI: 1730590852
Provider Name (Legal Business Name): JANA WELLS MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2014
Last Update Date: 06/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7947 PAINTER AVE
WHITTIER CA
90602-2414
US

IV. Provider business mailing address

1840 W WHITTIER BLVD SUIT 301
LA HABRA CA
90631-3623
US

V. Phone/Fax

Practice location:
  • Phone: 562-698-6089
  • Fax: 562-698-6222
Mailing address:
  • Phone: 562-698-6089
  • Fax: 562-698-6222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. JANA WELLS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 562-698-6089