| San Martin De Porres Medical Clinic Inc | |
|
9315 Telegraph Rd Pico Rivera CA 90660-5424 | |
| (562) 654-6855 | |
| (562) 654-6856 |
| Full Name | San Martin De Porres Medical Clinic Inc |
|---|---|
| Speciality | General Practice |
| Location | 9315 Telegraph Rd, Pico Rivera, California |
| Authorized Official Name and Position | Francisco Edgardo Paredes (OWNER) |
| Authorized Official Contact | 5626546855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Martin De Porres Medical Clinic Inc 9315 Telegraph Rd Pico Rivera CA 90660-5424 Ph: (562) 654-6855 | San Martin De Porres Medical Clinic Inc 9315 Telegraph Rd Pico Rivera CA 90660-5424 Ph: (562) 654-6855 |
| NPI Number | 1215953609 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 01/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215953609 | NPI | - | NPPES |
| ZZZ80011Z | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A24482 (California) | Primary |
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San Martin De Porres Medical Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9315 Telegraph Rd, Pico Rivera, CA 90660 Phone: 562-654-6855 |