Community Wellness Medical Clinic, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COMMUNITY WELLNESS MEDICAL CLINIC, INC

Practice address

1218 S Inglewood Ave
Inglewood, CA 90301-3649

Phone

(310) 722-5146

NPI assigned

Jul 25, 2019

Last updated

Aug 14, 2019By 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

Rose N Ekejiuba, NP

Title

Owner

Phone

(310) 722-5146

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565740800000",
    "number": "1821642059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1458 E GLADWICK ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907463804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 S INGLEWOOD AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903013649",
            "telephone_number": "310-722-5146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY WELLNESS MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-25",
        "last_updated": "2019-08-14",
        "status": "A",
        "authorized_official_last_name": "EKEJIUBA",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-722-5146",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniesha Colvin
• Jerome Comer, LCSW
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• Community Wellness Group
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• Complete Eye Care Center
• Comprehensive Dental Care
• Susan Comrie
• Lauren Cona, LCSW

• Family Medicine Physician in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.