Southgate Medical Clinic, P.S.

LBN: Southgate Medical Clinic, P.S.
Southgate Medical Clinic, P.S. is an health care organization with primary practice located at 6044 Martin Luther King Jr Way S Ste 104 , Seattle WA 98118-3179. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Southgate Medical Clinic, P.S. can be contacted via phone (206) 723-9853, or through Velasco, Roberto A via phone (206) 723-9853.

Contact Information

Primary practice address
6044 Martin Luther King Jr Way S Ste 104 Seattle WA 98118-3179
Phone: (206) 723-9853
Fax: (206) 723-0849
Website:
Map and Directions
Authorized official contact:
Name: Velasco, Roberto A Doctor of Medicine (MD)
Phone: (206) 723-9853

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X MD00022120 Washington

Profile Details

NPI number 1336254051
LBN Legal business name Southgate Medical Clinic, P.S.
DBA Doing business as
Authorized official Velasco, Roberto A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 20th, 2006
Last updated Aug 22nd, 2020 - about 4 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1336254051 NPPES
Washington MEDICAID 7033046
Washington Other VE4004

Popular Providers