| Medicina Familiar | |
|
13500 Van Nuys Blvd Pacoima CA 91331 | |
| (818) 896-2999 | |
| (818) 896-8449 |
| Full Name | Medicina Familiar |
|---|---|
| Speciality | General Practice |
| Location | 13500 Van Nuys Blvd, Pacoima, California |
| Authorized Official Name and Position | Jose Manuel Gonzalez-diaz (OWNER) |
| Authorized Official Contact | 8188962999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medicina Familiar 13500 Van Nuys Blvd Pacoima CA 91331-3028 Ph: (818) 896-2999 | Medicina Familiar 13500 Van Nuys Blvd Pacoima CA 91331 Ph: (818) 896-2999 |
| NPI Number | 1609961648 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 05/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609961648 | NPI | - | NPPES |
| GR0086101 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A41311 (California) | Primary |
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