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General NPI Number Information
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NPI Number | 1427488741
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Entity Type | Organization
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Legal Business Name | WELLCARE MEDICAL CLINIC. INC
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Dates
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Enumeration Date | 11/22/2013
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Last Update Date | 11/22/2013
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Provider Practice Location Address
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Address Line | 2990 E PACIFIC COAST HWY
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City | LONG BEACH
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State | CA
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Zip | 90804-1632
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Country | US
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Telephone | 562-343-7181
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Fax |
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Provider Business Mailing Address
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Address Line | 2990 E PACIFIC COAST HWY
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City | LONG BEACH
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State | CA
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Zip | 90804-1632
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Country | US
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Telephone | 562-343-7181
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ARTIS WOODWARD
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Credential | MD
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Telephone | 562-343-7181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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