NPIMap

Organization Active NPI

West Coast Medical Clinic Inc

  • Non-Pharmacy Dispensing Site
  • Wilmington, CA
National Provider Identifier
1679162747
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
WEST COAST MEDICAL CLINIC INC
Practice address
1703 N Avalon Blvd
Wilmington, CA 90744-1432
Phone
(310) 923-3030
NPI assigned
Jan 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Authorized official

Name
Cristal Dawn Speller Ricci, MD
Title
President
Phone
(310) 923-3030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

1703 N Avalon Blvd
Wilmington, CA 90744-1432

Mailing address

230 N Maryland Ave Ste 110
Glendale, CA 91206-4283
Phone (310) 923-3030

National Provider Directory

National Provider Directory
Tax ID family
Glendale Whole Health3 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": "1610496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610496000000",
    "number": "1679162747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N MARYLAND AVE STE 110",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064283",
            "telephone_number": "310-923-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 N AVALON BLVD",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907441432",
            "telephone_number": "310-923-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COAST MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "RICCI",
        "authorized_official_first_name": "CRISTAL",
        "authorized_official_middle_name": "DAWN SPELLER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-923-3030",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.