| San Miguel Medical Clinic, Inc | |
|
8204 Long Beach Blvd Suite B South Gate CA 90280-2011 | |
| (323) 588-3300 | |
| (323) 588-0855 |
| Full Name | San Miguel Medical Clinic, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8204 Long Beach Blvd, South Gate, California |
| Authorized Official Name and Position | Naim Salama (OWNER) |
| Authorized Official Contact | 3235883300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| San Miguel Medical Clinic, Inc 8204 Long Beach Blvd Suite B South Gate CA 90280-2011 Ph: (323) 588-3300 | San Miguel Medical Clinic, Inc 8204 Long Beach Blvd Suite B South Gate CA 90280-2011 Ph: (323) 588-3300 |
| NPI Number | 1801992565 |
|---|---|
| Provider Enumeration Date | 09/16/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8628388345 |
|---|---|
| Medicare Enrollment ID | O20151110001104 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801992565 | NPI | - | NPPES |
| GR0066650 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | FNP14677 (California) | Primary |
| Provider Name | Michael N Salama |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366734568 PECOS PAC ID: 4688811474 Enrollment ID: I20151110002249 |
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