| Los Reyes Cliinica Medica, Inc | |
|
7934 Seville Ave Walnut Park CA 90255-6804 | |
| (323) 583-9644 | |
| (323) 583-0012 |
| Full Name | Los Reyes Cliinica Medica, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 7934 Seville Ave, Walnut Park, California |
| Authorized Official Name and Position | Myra Gomez (ADMINISTRATOR) |
| Authorized Official Contact | 3235849644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Los Reyes Cliinica Medica, Inc 7934 Seville Ave Huntington Park CA 90255-6804 Ph: (323) 584-9644 | Los Reyes Cliinica Medica, Inc 7934 Seville Ave Walnut Park CA 90255-6804 Ph: (323) 583-9644 |
| NPI Number | 1952461774 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 10/09/2012 |
| Medicare PECOS PAC ID | 2668570243 |
|---|---|
| Medicare Enrollment ID | O20070605000429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952461774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jawahar Sundaram |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720082100 PECOS PAC ID: 3274593843 Enrollment ID: I20041018000840 |
| Provider Name | Edgar Reyes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891738324 PECOS PAC ID: 4082655345 Enrollment ID: I20050517000433 |
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