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10408 Vacco St Suite A South El Monte CA 91733-3328 | |
| (626) 486-9640 | |
| (626) 486-9654 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 10408 Vacco St, South El Monte, California |
| Authorized Official Name and Position | Margaret Banda Martinez (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6269931227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
455 W Montana St Pasadena CA 91103-1327 Ph: (626) 993-1212 | 10408 Vacco St Suite A South El Monte CA 91733-3328 Ph: (626) 486-9640 |
| NPI Number | 1578808200 |
|---|---|
| Provider Enumeration Date | 12/06/2012 |
| Last Update Date | 11/12/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578808200 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 550002384 (California) | Primary |
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