San Martin De Porres Medical Clinic Of South Gate, Inc

LBN: San Martin De Porres Medical Clinic Of South Gate, Inc
San Martin De Porres Medical Clinic Of South Gate, Inc is an health care organization with primary practice located at 10001 California Ave , South Gate CA 90280-6005. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as the primary health care specialty. San Martin De Porres Medical Clinic Of South Gate, Inc can be contacted via phone (323) 564-4408, or through Consiglieri, Ana via phone (323) 564-4408.

Contact Information

Primary practice address
10001 California Ave South Gate CA 90280-6005
Phone: (323) 564-4408
Fax: (323) 564-9641
Website:
Map and Directions
Authorized official contact:
Name: Consiglieri, Ana
Phone: (323) 564-4408

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X

Profile Details

NPI number 1134298318
LBN Legal business name San Martin De Porres Medical Clinic Of South Gate, Inc
DBA Doing business as
Authorized official Consiglieri, Ana
Entity Organization
Organization subpart 1 No
Enumeration date Nov 6th, 2006
Last updated Oct 6th, 2014 - about 11 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 1134298318 NPPES
California MEDICAID GR0061920

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