| Clinica Maria Medical Center | |
|
8100 California Ave Suite K South Gate CA 90280-2469 | |
| (323) 357-1000 | |
| (323) 357-1001 |
| Full Name | Clinica Maria Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 8100 California Ave, South Gate, California |
| Authorized Official Name and Position | Rosalind George Pallivathucal (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3233571000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica Maria Medical Center 8100 California Ave South Gate CA 90280-2469 Ph: (323) 357-1000 | Clinica Maria Medical Center 8100 California Ave Suite K South Gate CA 90280-2469 Ph: (323) 357-1000 |
| NPI Number | 1033244611 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 07/23/2009 |
| Medicare PECOS PAC ID | 5294889507 |
|---|---|
| Medicare Enrollment ID | O20090821000098 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033244611 | NPI | - | NPPES |
| 0A43918 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A43918 (California) | Primary |
| Provider Name | Rosalind G Pallivathucal |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1437311131 PECOS PAC ID: 2264586072 Enrollment ID: I20090813000227 |
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