| Lucita M Cruz Md Inc | |
|
12507 Alondra Blvd Norwalk CA 90650-7351 | |
| (562) 802-2203 | |
| (562) 404-8555 |
| Full Name | Lucita M Cruz Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 12507 Alondra Blvd, Norwalk, California |
| Authorized Official Name and Position | Lucita Cruz (OWNER) |
| Authorized Official Contact | 5628022203 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lucita M Cruz Md Inc 12507 Alondra Blvd Norwalk CA 90650-7351 Ph: (562) 802-2203 | Lucita M Cruz Md Inc 12507 Alondra Blvd Norwalk CA 90650-7351 Ph: (562) 802-2203 |
| NPI Number | 1114229762 |
|---|---|
| Provider Enumeration Date | 12/01/2010 |
| Last Update Date | 01/22/2015 |
| Medicare PECOS PAC ID | 2264620434 |
|---|---|
| Medicare Enrollment ID | O20110103001046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114229762 | NPI | - | NPPES |
| C1729665 | Other | CA | CA SECRETARY OF STATE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A37419 (California) | Primary |
| 207R00000X | Internal Medicine | A37419 (California) | Secondary |
| Provider Name | Lucita Menchavez Cruz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770526477 PECOS PAC ID: 3173711348 Enrollment ID: I20110103001054 |
| Provider Name | Jacqueline Charmaine Frigillana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255937595 PECOS PAC ID: 5092187856 Enrollment ID: I20230206000644 |
| Provider Name | Jennifer Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689309130 PECOS PAC ID: 2668844432 Enrollment ID: I20230206000956 |
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