| Del Rosario Medical Clinic, Inc. | |
|
3400 E Florence Ave Huntington Park CA 90255-5835 | |
| (323) 589-9384 | |
| (323) 589-0358 |
| Full Name | Del Rosario Medical Clinic, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 3400 E Florence Ave, Huntington Park, California |
| Authorized Official Name and Position | Graciela Calatayud (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3235899384 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Del Rosario Medical Clinic, Inc. 3400 E Florence Ave Huntington Park CA 90255-5835 Ph: (323) 589-9384 | Del Rosario Medical Clinic, Inc. 3400 E Florence Ave Huntington Park CA 90255-5835 Ph: (323) 589-9384 |
| NPI Number | 1659419307 |
|---|---|
| Provider Enumeration Date | 02/02/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1254221534 |
|---|---|
| Medicare Enrollment ID | O20110506000291 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659419307 | NPI | - | NPPES |
| GR0070720 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (California) | Primary |
| Provider Name | Graciela Graciela Calatayud |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1336252352 PECOS PAC ID: 4789574070 Enrollment ID: I20110506000302 |
| Provider Name | Maria D Nunez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598002875 PECOS PAC ID: 7416274808 Enrollment ID: I20150324000784 |
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