Clinica Medica Familiar San Judas Inc | |
3900 W 3rd St Los Angeles CA 90020-2675 | |
(213) 427-0400 | |
Not Available |
Full Name | Clinica Medica Familiar San Judas Inc |
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Speciality | Family Medicine |
Location | 3900 W 3rd St, Los Angeles, California |
Authorized Official Name and Position | Jose A Ortiz (OWNER) |
Authorized Official Contact | 2134270400 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Clinica Medica Familiar San Judas Inc 3900 W 3rd St Los Angeles CA 90020-2675 Ph: (213) 427-0400 | Clinica Medica Familiar San Judas Inc 3900 W 3rd St Los Angeles CA 90020-2675 Ph: (213) 427-0400 |
NPI Number | 1225254055 |
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Provider Enumeration Date | 04/18/2007 |
Last Update Date | 12/11/2020 |
Medicare PECOS PAC ID | 0941351886 |
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Medicare Enrollment ID | O20090706000444 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225254055 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | A73634 (California) | Primary |
207RP1001X | Internal Medicine - Pulmonary Disease | (* (Not Available)) | Secondary |
Provider Name | Jose A Ortiz |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1134218555 PECOS PAC ID: 3678624517 Enrollment ID: I20090706000440 |
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