NPIMap

Organization Active NPI

JWCH Institute, Inc

Doing business as JWCH Medical Clinic @ Charles Cobb

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
National Provider Identifier
1801456439
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
JWCH INSTITUTE, INC
Doing business as
JWCH Medical Clinic @ Charles Cobb
Practice address
521 S San Pedro St
Los Angeles, CA 90013-2148
Phone
(213) 353-1118
NPI assigned
Jun 17, 2019
Last updated
Jun 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Authorized official

Name
Alvaro P Ballesteros
Title
Chief Executive Officer
Phone
(323) 201-4516

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

521 S San Pedro St
Los Angeles, CA 90013-2148

Mailing address

5650 Jillson St
Commerce, CA 90040-1482
Phone (323) 201-4516

Other names 1

  • JWCH Medical Clinic @ Charles Cobb Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2004070JWCH Medical Clinic521 S San Pedro St, Los Angeles, CA 90013Certificate of waiverFeb 23, 2028

National Provider Directory

National Provider Directory
Tax ID family
Wesley Health Centers - Midnight Mission69 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560729600000",
    "number": "1801456439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 JILLSON ST",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900401482",
            "telephone_number": "323-201-4516",
            "fax_number": "323-215-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 S SAN PEDRO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900132148",
            "telephone_number": "213-353-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JWCH INSTITUTE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A",
        "authorized_official_last_name": "BALLESTEROS",
        "authorized_official_first_name": "ALVARO",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "323-201-4516"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JWCH Medical Clinic @ Charles Cobb",
            "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 Jun 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.