Green Wells Eecp Physical Therapy

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

Legal business name

GREEN WELLS EECP PHYSICAL THERAPY

Practice address

8602 Elburg Street Apt C
Paramount, CA 90723

Phone

(310) 405-1478

NPI assigned

Dec 17, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jared Jason Wells

Title

Owner/Chief Techician

Phone

(310) 405-1478

Specialties & licenses 1

Addresses

Other names 1

• green wells eecp Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261008000000",
    "number": "1013246222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8602 ELBURG ST UNIT C",
            "address_2": "7136 PACIFIC BLVD SUITE 220",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907238632",
            "telephone_number": "323-588-5467",
            "fax_number": "323-589-6662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8602 ELBURG STREET APT C",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "90723",
            "telephone_number": "310-405-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN WELLS EECP PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-17",
        "last_updated": "2009-12-17",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "OWNER/CHIEF TECHICIAN",
        "authorized_official_telephone_number": "310-405-1478",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "green wells eecp",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Luz Edith Ortiz Gomez
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• Jesus Gonzalez, PA-C
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• Fernando Guerrero

• Physical Disabilities Residential Treatment Facility in Paramount, CA
• Providers in Paramount, CA by specialty
• Physical Disabilities Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.