| NPI | 1801456439 |
|---|---|
| Doing Business As | JWCH MEDICAL CLINIC @ CHARLES COBB |
| Entity Type | Organization |
| Authorized Contact | ALVARO P BALLESTEROS Chief Executive Officer 323-201-4516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2019-06-17 |