NPIMap

Organization Active NPI

Watts Healthcare Corporation

Doing business as Jordan Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
National Provider Identifier
1376681486
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
96000449 Issued in CA
Legal business name
WATTS HEALTHCARE CORPORATION
Doing business as
Jordan Wellness Center
Practice address
10300 Compton Ave
Los Angeles, CA 90002-3628
Phone
(323) 357-6680
Fax
(323) 563-6378
NPI assigned
Feb 1, 2007
Last updated
Sep 12, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
WATTS HEALTHCARE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Authorized official

Name
Mr. William D. Hobson Jr.
Title
President & Ceo
Phone
(323) 568-4417

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 96000449 CA Primary

Addresses

Primary practice location

10300 Compton Ave
Los Angeles, CA 90002-3628

Mailing address

10110 Juniper Street
Los Angeles, CA 90002
Phone (323) 357-6680

Other identifiers 1

IdentifierTypeStateIssuer
FHC70422GMedicaidCA

Other names 1

  • Jordan Wellness Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Watts Healthcare Corporation5 organizations share this tax ID, including this one
Part of
Watts Healthcare Corporation

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1376681486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10110 JUNIPER STREET",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90002",
            "telephone_number": "323-357-6680",
            "fax_number": "323-563-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 COMPTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900023628",
            "telephone_number": "323-357-6680",
            "fax_number": "323-563-6378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATTS HEALTHCARE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WATTS HEALTHCARE CORPORATION",
        "enumeration_date": "2007-02-01",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "HOBSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "323-568-4417",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "96000449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70422G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jordan Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.