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7910 Atlantic Ave Ste M Cudahy CA 90201-5774 | |
(323) 908-4247 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 7910 Atlantic Ave Ste M, Cudahy, California |
Authorized Official Name and Position | Richard Veloz (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 3239084247 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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4425 S Central Ave Los Angeles CA 90011-3629 Ph: (323) 908-4247 | 7910 Atlantic Ave Ste M Cudahy CA 90201-5774 Ph: (323) 908-4247 |
NPI Number | 1982063939 |
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Provider Enumeration Date | 02/18/2016 |
Last Update Date | 10/08/2018 |
Medicare PECOS PAC ID | 5597675041 |
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Medicare Enrollment ID | O20180605001527 |
Identifier | Type | State | Issuer |
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1982063939 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Clinica Santa Clara Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7643 Atlantic Ave, Cudahy, CA 90201 Phone: 323-771-1713 Fax: 323-562-1302 | |