Maywood Healthcare Clinic, Inc. | |
4205 Slauson Ave Maywood CA 90270-2835 | |
(323) 560-0118 | |
(323) 560-1302 |
Full Name | Maywood Healthcare Clinic, Inc. |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 4205 Slauson Ave, Maywood, California |
Authorized Official Name and Position | Rey Quinonez (ADMINISTRATOR) |
Authorized Official Contact | 3238611510 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Maywood Healthcare Clinic, Inc. 4205 Slauson Ave Maywood CA 90270-2835 Ph: (323) 560-0118 | Maywood Healthcare Clinic, Inc. 4205 Slauson Ave Maywood CA 90270-2835 Ph: (323) 560-0118 |
NPI Number | 1013343078 |
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Provider Enumeration Date | 09/23/2013 |
Last Update Date | 09/03/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013343078 | NPI | - | NPPES |
PA1756 | Other | CA | PA-C CA LIC # |
PA19411 | Other | CA | PA-C CA LIC # |
A70433 | Other | CA | MD CA LIC # |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | A70433 (California) | Secondary |
261QP2300X | Clinic/center - Primary Care | A70433 (California) | Primary |
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