| Complete Family Medical Clinic | |
|
5540 N Figueroa St Los Angeles CA 90042-4120 | |
| (323) 478-1101 | |
| (323) 255-2745 |
| Full Name | Complete Family Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 5540 N Figueroa St, Los Angeles, California |
| Authorized Official Name and Position | Jagan Nath Bansal (CEO) |
| Authorized Official Contact | 3234781101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Complete Family Medical Clinic 5540 N Figueroa St Los Angeles CA 90042-4120 Ph: (323) 478-1101 | Complete Family Medical Clinic 5540 N Figueroa St Los Angeles CA 90042-4120 Ph: (323) 478-1101 |
| NPI Number | 1043392962 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 01/23/2013 |
| Medicare PECOS PAC ID | 9739127515 |
|---|---|
| Medicare Enrollment ID | O20050421000957 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043392962 | NPI | - | NPPES |
| GR0014481 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jagan N Bansal |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1932102456 PECOS PAC ID: 9335187111 Enrollment ID: I20050422000475 |
| Provider Name | Maneesh A Bansal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063615102 PECOS PAC ID: 9032219860 Enrollment ID: I20070710000306 |
| Provider Name | David Noam Kay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205254992 PECOS PAC ID: 9931491180 Enrollment ID: I20170131000012 |
| Provider Name | Tyeshia Monika Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104276419 PECOS PAC ID: 7012281322 Enrollment ID: I20170926002317 |
| Provider Name | Alfonso V Pastores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700335494 PECOS PAC ID: 8022395417 Enrollment ID: I20171108003875 |
| Provider Name | Amy Bansal |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1437569613 PECOS PAC ID: 4789012550 Enrollment ID: I20210831003301 |
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