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4811 Elizabeth St Cudahy CA 90201-5205 | |
| (323) 908-4200 | |
| (323) 908-4256 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 4811 Elizabeth St, Cudahy, California |
| Authorized Official Name and Position | Richard Veloz (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3239084247 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4425 S Central Ave Los Angeles CA 90011-3629 Ph: (323) 908-4247 | 4811 Elizabeth St Cudahy CA 90201-5205 Ph: (323) 908-4200 |
| NPI Number | 1356897243 |
|---|---|
| Provider Enumeration Date | 08/30/2016 |
| Last Update Date | 07/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356897243 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (California) | Primary |
Clinica Santa Clara Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7643 Atlantic Ave, Cudahy, CA 90201 Phone: 323-771-1713 Fax: 323-562-1302 | |