JMK COMMUNITY HEALTH CENTER INC NPI 1083155824

NPI Information

JMK COMMUNITY HEALTH CENTER, INC is a family nurse practitioner in Gardena, CA. JMK COMMUNITY HEALTH CENTER, INC NPI is 1083155824. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

14111 VAN NESS AVE
SUITE 5
GARDENA, CA
ZIP 90249-950
Phone: (424) 396-3412
Fax: (424) 396-3427

The provider's authorized official is Jeanette Monique Kidd .
The authorized official title is Ceo and has the following contact phone number (424) 396-3412.

The CLIA number assigned to this NPI record is 05D2133842 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/13/2017 and was last updated on 11/6/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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