| San Antonio Medical Clinic, Inc. | |
|
325 E La Habra Blvd La Habra CA 90631-5439 | |
| (562) 691-7100 | |
| (562) 691-7101 |
| Full Name | San Antonio Medical Clinic, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 325 E La Habra Blvd, La Habra, California |
| Authorized Official Name and Position | Juan Atlacatl Alas (PRESIDENT) |
| Authorized Official Contact | 5626917100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| San Antonio Medical Clinic, Inc. 325 E La Habra Blvd La Habra CA 90631-5439 Ph: (562) 691-7100 | San Antonio Medical Clinic, Inc. 325 E La Habra Blvd La Habra CA 90631-5439 Ph: (562) 691-7100 |
| NPI Number | 1285845503 |
|---|---|
| Provider Enumeration Date | 05/25/2007 |
| Last Update Date | 12/28/2010 |
| Medicare PECOS PAC ID | 1254413701 |
|---|---|
| Medicare Enrollment ID | O20080123000640 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285845503 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A56155 (California) | Primary |
| Provider Name | Juan A Alas Pocasangre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720189186 PECOS PAC ID: 5698705796 Enrollment ID: I20050818000294 |
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