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General NPI Number Information
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NPI Number | 1275739807
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Entity Type | Organization
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Legal Business Name | J H WELLS M D A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2880 ATLANTIC AVE SUITE 290
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City | LONG BEACH
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State | CA
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Zip | 90806-1714
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Country | US
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Telephone | 562-595-6543
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Fax | 562-595-1414
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Provider Business Mailing Address
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Address Line | 2880 ATLANTIC AVE STE 290
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City | LONG BEACH
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State | CA
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Zip | 90806-1716
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Country | US
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Telephone | 562-595-6543
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Fax | 562-595-1414
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES H WELLS
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Credential | M.D.
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Telephone | 562-595-6543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | C33481
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License Number State | CA
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