| Clinica Medica Latina, Inc | |
|
24805 Alessandro Blvd Ste 8 Moreno Valley CA 92553-6101 | |
| (951) 601-6618 | |
| (951) 247-6218 |
| Full Name | Clinica Medica Latina, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 24805 Alessandro Blvd Ste 8, Moreno Valley, California |
| Authorized Official Name and Position | Lorenzo Moises Vazquez (CEO / OWNER) |
| Authorized Official Contact | 9516016618 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica Medica Latina, Inc 24805 Alessandro Blvd Ste 8 Moreno Valley CA 92553-6101 Ph: (951) 601-6618 | Clinica Medica Latina, Inc 24805 Alessandro Blvd Ste 8 Moreno Valley CA 92553-6101 Ph: (951) 601-6618 |
| NPI Number | 1922582592 |
|---|---|
| Provider Enumeration Date | 09/19/2018 |
| Last Update Date | 09/19/2018 |
| Medicare PECOS PAC ID | 4587090261 |
|---|---|
| Medicare Enrollment ID | O20200129001858 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922582592 | NPI | - | NPPES |
| A70384 | Other | CA | PROFESSIONAL LICENSE |
| . | Other | . |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lorenzo M Vazquez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760521322 PECOS PAC ID: 2264417609 Enrollment ID: I20040621001272 |
Riverside University Health System Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 26520 Cactus Ave, Moreno Valley, CA 92555 Phone: 951-486-4000 Fax: 951-486-4435 | |
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Joel A Pengson, Md, A Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 23180 Hemlock Ave, Moreno Valley, CA 92557 Phone: 951-243-6460 | |
John Liquete Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14114 Business Center Dr, Suite D, Moreno Valley, CA 92553 Phone: 951-697-1150 | |
Yogendra B Patel,md,inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12980 Frederick St, Suite J, Moreno Valley, CA 92553 Phone: 951-924-9300 Fax: 951-485-0240 |