| NPI | 1417836925 |
|---|---|
| Doing Business As | WILSHIRE BLVD 360 CLINIC |
| Entity Type | Organization |
| Authorized Contact | JEREMY CHURCH CFO 323-442-8747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2025-08-28 |
| Last Update Date | 2025-08-28 |