Eastside Family Clinic
LBN: Eastside Family Medical Associates, Inc.
Eastside Family Clinic is an health care organization with primary practice located at 321 S Mednik Ave , Los Angeles CA 90022-1839. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Multi-Specialty. Ambulatory Health Care Facilities / Multi-Specialty is the primary health care specialty.
Eastside Family Medical Associates, Inc. can be contacted via phone (323) 261-4706, or through Gonzalez, Enrique J. via phone (323) 261-4706.
Contact Information
Primary practice address
321 S Mednik Ave
Los Angeles CA 90022-1839
Phone: (323) 261-4706
Fax: (323) 261-4124
Website:
Authorized official contact:
Name: Gonzalez, Enrique J. Doctor of Medicine (MD)
Phone: (323) 261-4706
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X | G74790 | California |
| Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X |
Profile Details
| NPI number | 1568656791 |
|---|---|
| LBN Legal business name | Eastside Family Medical Associates, Inc. |
| DBA Doing business as | Eastside Family Clinic |
| Authorized official | Gonzalez, Enrique J. Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 30th, 2007 |
| Last updated | Mar 29th, 2022 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568656791 | NPPES |
| California | MEDICAID | 00G747901 |
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