| Casa Guadalupe Family Medical Clinic | |
|
2015 W 1st St Ste K Santa Ana CA 92703-3516 | |
| (714) 547-7745 | |
| Not Available |
| Full Name | Casa Guadalupe Family Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 2015 W 1st St Ste K, Santa Ana, California |
| Authorized Official Name and Position | Nancy Garrett (OWNER) |
| Authorized Official Contact | 2139234074 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Casa Guadalupe Family Medical Clinic 2015 W. 1st Suite K Santa Ana CA 92703 Ph: (714) 547-7745 | Casa Guadalupe Family Medical Clinic 2015 W 1st St Ste K Santa Ana CA 92703-3516 Ph: (714) 547-7745 |
| NPI Number | 1487799185 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 02/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487799185 | NPI | - | NPPES |
| GR0063230 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 166649 (California) | Primary |
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