NPIMap

Organization Active NPI

West Gardena Community Clinic

  • Point of Service
  • Gardena, CA
National Provider Identifier
1538575303
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
Legal business name
WEST GARDENA COMMUNITY CLINIC
Practice address
2233 W Rosecrans Ave
Gardena, CA 90249-2905
Phone
(310) 766-2500
Fax
(866) 329-0742
NPI assigned
Jul 1, 2014
Last updated
Jul 1, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

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

Authorized official

Name
Ms. Elaine Emma Wynn
Title
Officer
Phone
(310) 766-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X Primary

Addresses

Primary practice location

2233 W Rosecrans Ave
Gardena, CA 90249-2905

Mailing address

2233 W Rosecrans Ave
Gardena, CA 90249-2905
Phone (310) 766-2500

National Provider Directory

National Provider Directory
Tax ID family
New Faith Transitional Living3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1404172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404172800000",
    "number": "1538575303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 W ROSECRANS AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902492905",
            "telephone_number": "310-766-2500",
            "fax_number": "866-329-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 W ROSECRANS AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902492905",
            "telephone_number": "310-766-2500",
            "fax_number": "866-329-0742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST GARDENA COMMUNITY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-01",
        "last_updated": "2014-07-01",
        "status": "A",
        "authorized_official_last_name": "WYNN",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "EMMA",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "310-766-2500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; 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.