Balwin Clinic INC
Family Medicine in Inglewood, CA. Organization (NPI-2).
NPI number1669923454
StatusActive
Last updated in NPPESOct 18, 2016
Details
- NPI
- 1669923454
- Entity type
- Organization (NPI-2)
- Legal business name
- Balwin Clinic INC
- Organization subpart
- No
- Enumeration date
- Oct 18, 2016
- Last updated
- Oct 18, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
4508 W Imperial Hwy # BInglewood, CA 90304-2710
Phone 213-718-1473
Mailing address
3700 Wilshire BlvdSuite 422
Los Angeles, CA 90010-2901
Authorized official
Jacob Edem
Administrator
2137181473
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