| Eric A. Enriquez, M.d. Inc | |
|
14623 Hawthorne Blvd Suite 202 Lawndale CA 90260-1581 | |
| (310) 973-8863 | |
| (310) 973-1623 |
| Full Name | Eric A. Enriquez, M.d. Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 14623 Hawthorne Blvd, Lawndale, California |
| Authorized Official Name and Position | Eric A Enriquez (PRESIDENT) |
| Authorized Official Contact | 3109738863 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eric A. Enriquez, M.d. Inc 14623 Hawthorne Blvd Suite 202 Lawndale CA 90260-1581 Ph: (310) 973-8863 | Eric A. Enriquez, M.d. Inc 14623 Hawthorne Blvd Suite 202 Lawndale CA 90260-1581 Ph: (310) 973-8863 |
| NPI Number | 1073540597 |
|---|---|
| Provider Enumeration Date | 06/28/2006 |
| Last Update Date | 04/30/2010 |
| Medicare PECOS PAC ID | 9133175466 |
|---|---|
| Medicare Enrollment ID | O20050329001278 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073540597 | NPI | - | NPPES |
| 00A827020 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A82702 (California) | Primary |
| Provider Name | Eric A Enriquez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225038573 PECOS PAC ID: 6709854540 Enrollment ID: I20040920001215 |
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