Mid-Wilshire Health Care Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

970000071 Issued in CA

Legal business name

MID-WILSHIRE HEALTH CARE CENTER

Practice address

676 S Bonnie Brae St
Los Angeles, CA 90057-3710

Phone

(213) 483-9921

Fax

(213) 483-3606

NPI assigned

Nov 16, 2006

Last updated

Oct 15, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Jeoung Hie Lee

Title

President

Phone

(323) 934-5660

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Mid-Wilshire Health Care Center

  dba Fidelity Health Care

  • Skilled Nursing Facility
  • El Monte, CA
  • NPI 1194898205

  Member Of

  NPD member

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381795200000",
    "number": "1528131612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900193112",
            "telephone_number": "323-934-5660",
            "fax_number": "323-934-0852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 S BONNIE BRAE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573710",
            "telephone_number": "213-483-9921",
            "fax_number": "213-483-3606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-WILSHIRE HEALTH CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2013-10-15",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JEOUNG",
        "authorized_official_middle_name": "HIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-934-5660",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "970000071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT06174J",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paola Micozzi, CMT
• Mid City Associated Medical Group, Inc. (Clinica de Salud Familiar)
• Mid Wilshire Hospice
• Mid Wilshire Pharmacy
• Mid-Valley Imaging, LLC
• Mid-Wilshire Surgery Center,LLC
• Erica Miday
• Angela Michelle Middlebrook
• Ebony S Middlebrook, B.A.
• Holly Ruth Middlekauff, MD

• Skilled Nursing Facility in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.