| Cuidado Latino Medical Clinic Inc. | |
|
3710 Cesar Chavez Ave Los Angeles CA 90063-2219 | |
| (323) 980-7777 | |
| (323) 980-7778 |
| Full Name | Cuidado Latino Medical Clinic Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 3710 Cesar Chavez Ave, Los Angeles, California |
| Authorized Official Name and Position | Mori Shaw (ADMINISTRATOR) |
| Authorized Official Contact | 3239807777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cuidado Latino Medical Clinic Inc. 3710 Cesar Chavez Ave Los Angeles CA 90063-2219 Ph: (323) 980-7777 | Cuidado Latino Medical Clinic Inc. 3710 Cesar Chavez Ave Los Angeles CA 90063-2219 Ph: (323) 980-7777 |
| NPI Number | 1376862607 |
|---|---|
| Provider Enumeration Date | 05/26/2010 |
| Last Update Date | 05/26/2010 |
| Medicare PECOS PAC ID | 6406028133 |
|---|---|
| Medicare Enrollment ID | O20110930000473 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376862607 | NPI | - | NPPES |
| 1720077662 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A75388 (California) | Primary |
| Provider Name | Pauline J Jose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720077662 PECOS PAC ID: 5799746384 Enrollment ID: I20041026001175 |
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