| Azul Medical Clinic Inc | |
|
6517 Eastern Ave Bell Gardens CA 90201-3003 | |
| (323) 773-8295 | |
| (323) 773-0656 |
| Full Name | Azul Medical Clinic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6517 Eastern Ave, Bell Gardens, California |
| Authorized Official Name and Position | Francisco A Jimenez (PRESIDENT) |
| Authorized Official Contact | 3237738295 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Azul Medical Clinic Inc 6517 Eastern Ave Bell Gardens CA 90201-3003 Ph: (323) 773-8295 | Azul Medical Clinic Inc 6517 Eastern Ave Bell Gardens CA 90201-3003 Ph: (323) 773-8295 |
| NPI Number | 1679626436 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 10/07/2014 |
| Medicare PECOS PAC ID | 9436149168 |
|---|---|
| Medicare Enrollment ID | O20040514000879 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679626436 | NPI | - | NPPES |
| GR0095220 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A40305 (California) | Primary |
| 261QP2300X | Clinic/center - Primary Care | 17679 (California) | Secondary |
| Provider Name | Francisco A Jimenez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1972696573 PECOS PAC ID: 2062493059 Enrollment ID: I20040526000527 |
| Provider Name | Angel G Perez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477654440 PECOS PAC ID: 4981625829 Enrollment ID: I20051207000828 |
| Provider Name | Vanessa L Mansilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568634723 PECOS PAC ID: 1759443658 Enrollment ID: I20081231000527 |
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