| Clinica Medica San Judas Tadeo | |
|
501 E Hardy St Ste 110 Inglewood CA 90301-4015 | |
| (424) 800-2124 | |
| (424) 800-2454 |
| Full Name | Clinica Medica San Judas Tadeo |
|---|---|
| Speciality | Clinic/Center |
| Location | 501 E Hardy St Ste 110, Inglewood, California |
| Authorized Official Name and Position | Odilia Walsh (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5627062433 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica Medica San Judas Tadeo 501 E Hardy St Ste 110 Inglewood CA 90301-4015 Ph: (424) 800-2124 | Clinica Medica San Judas Tadeo 501 E Hardy St Ste 110 Inglewood CA 90301-4015 Ph: (424) 800-2124 |
| NPI Number | 1962139568 |
|---|---|
| Provider Enumeration Date | 08/03/2022 |
| Last Update Date | 08/21/2024 |
| Medicare PECOS PAC ID | 7618330044 |
|---|---|
| Medicare Enrollment ID | O20230831003013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962139568 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
| Provider Name | Richard C Keech |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487748364 PECOS PAC ID: 8123013745 Enrollment ID: I20040414001824 |
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