San Manuel Medical Clinic,Inc

LBN: San Manuel Medical Clinic,Inc
San Manuel Medical Clinic,Inc is an health care organization with primary practice located at 7400 Pacific Blvd Ste A , Walnut Park CA 90255-5739. The organization recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Family Medicine. Other Service Providers / Specialist is the primary health care specialty. San Manuel Medical Clinic,Inc can be contacted via phone (323) 585-8881, or through Webb, Elia via phone (323) 585-8881.

Contact Information

Primary practice address
7400 Pacific Blvd Ste A Walnut Park CA 90255-5739
Fax:
Website:
Authorized official contact:
Name: Webb, Elia

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X A84082 California
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1831456482
LBN Legal business name San Manuel Medical Clinic,Inc
DBA Doing business as
Authorized official Webb, Elia
Entity Organization
Organization subpart 1 No
Enumeration date Apr 20th, 2012
Last updated Apr 20th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831456482 NPPES
California MEDICAID GR0100930

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