| Vermont Family And Women's Clinic, Inc | |
|
1200 N Vermont Ave Suite E Los Angeles CA 90029-1760 | |
| (805) 610-2821 | |
| Not Available |
| Full Name | Vermont Family And Women's Clinic, Inc |
|---|---|
| Speciality | General Practice |
| Location | 1200 N Vermont Ave, Los Angeles, California |
| Authorized Official Name and Position | Clem D Rodriguez (CEO) |
| Authorized Official Contact | 8056102821 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vermont Family And Women's Clinic, Inc 1200 N Vermont Ave Suite E Los Angeles CA 90029-1760 Ph: () - | Vermont Family And Women's Clinic, Inc 1200 N Vermont Ave Suite E Los Angeles CA 90029-1760 Ph: (805) 610-2821 |
| NPI Number | 1225476534 |
|---|---|
| Provider Enumeration Date | 06/08/2013 |
| Last Update Date | 06/08/2013 |
| Medicare PECOS PAC ID | 5496998163 |
|---|---|
| Medicare Enrollment ID | O20130828000157 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225476534 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A52544 (California) | Primary |
| Provider Name | Clem Rodriguez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1134394034 PECOS PAC ID: 6305089079 Enrollment ID: I20130828000189 |
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