NPI 1023295276

Evergreen Wellness Center INC.

Organisation Health Maintenance Organization Los Angeles, CA

Practice location

Address: 2950 Los Feliz Blvd 203, Los Angeles, CA 90039-1532
Phone: (323) 665-1985

Authorised official

Name: Joan Kim-Wagner
Title: President
Phone: (323) 665-1985

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence AC9278 (CA)

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Registry record

NPI: 1023295276
Entity type: Organization
NPI issued: 29 Jan 2008
Record last updated: 1 Nov 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.