The Vidal Womans Medical Clinic Inc | |
11502 S Vermont Ave Ste B Los Angeles CA 90044-6522 | |
(323) 755-5500 | |
(323) 755-5522 |
Full Name | The Vidal Womans Medical Clinic Inc |
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Speciality | Clinic/Center |
Location | 11502 S Vermont Ave Ste B, Los Angeles, California |
Authorized Official Name and Position | Martha G. Vidal (PRESIDENT) |
Authorized Official Contact | 3237555500 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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The Vidal Womans Medical Clinic Inc 1601 N Sepulveda Blvd # 400 Manhattan Beach CA 90266-5111 Ph: (323) 755-5500 | The Vidal Womans Medical Clinic Inc 11502 S Vermont Ave Ste B Los Angeles CA 90044-6522 Ph: (323) 755-5500 |
NPI Number | 1326133687 |
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Provider Enumeration Date | 10/04/2006 |
Last Update Date | 01/27/2025 |
Medicare PECOS PAC ID | 5395100341 |
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Medicare Enrollment ID | O20230427000838 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326133687 | NPI | - | NPPES |
00A780690 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Martha Gonzalez De Vidal |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1437248630 PECOS PAC ID: 6406211358 Enrollment ID: I20230427001382 |
Joseph I Kang Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3755 Beverly Blvd, Ste 301, Los Angeles, CA 90004 Phone: 323-664-7777 | |
John L Sherman Md Amc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8635 W 3rd St Ste 485w, Los Angeles, CA 90048 Phone: 310-855-8081 Fax: 310-855-0438 | |
Altamed Health Services Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5425 Pomona Blvd, Los Angeles, CA 90022 Phone: 323-832-7527 Fax: 323-832-7599 | |