| Doctor Paul Memorial Medical Center | |
|
501 E Hardy St Ste 220 Inglewood CA 90301-4054 | |
| (323) 290-2832 | |
| (323) 290-2836 |
| Full Name | Doctor Paul Memorial Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 501 E Hardy St Ste 220, Inglewood, California |
| Authorized Official Name and Position | Mezia Ogugua Azinge (PRESIDENT/CEO) |
| Authorized Official Contact | 3232902832 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Doctor Paul Memorial Medical Center 501 E Hardy St Ste 220 Inglewood CA 90301-4054 Ph: (323) 290-2832 | Doctor Paul Memorial Medical Center 501 E Hardy St Ste 220 Inglewood CA 90301-4054 Ph: (323) 290-2832 |
| NPI Number | 1659379634 |
|---|---|
| Provider Enumeration Date | 07/13/2005 |
| Last Update Date | 08/06/2020 |
| Medicare PECOS PAC ID | 7315016524 |
|---|---|
| Medicare Enrollment ID | O20080514000328 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659379634 | NPI | - | NPPES |
| 00A534491 | Medicaid | CA | |
| 00A53449 | Medicaid | CA | |
| 00A534492 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | A53449 (California) | Primary |
| Provider Name | Mezia Ogugua Azinge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689707259 PECOS PAC ID: 9032288246 Enrollment ID: I20080514000381 |
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