| Isaias De Guzman Paja Jr. Md Inc | |
|
1800 Wilshire Blvd Los Angeles CA 90057-3602 | |
| (213) 484-9934 | |
| (213) 484-9939 |
| Full Name | Isaias De Guzman Paja Jr. Md Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1800 Wilshire Blvd, Los Angeles, California |
| Authorized Official Name and Position | Isaias Paja (OWNER) |
| Authorized Official Contact | 2134849934 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Isaias De Guzman Paja Jr. Md Inc 1800 Wilshire Blvd Los Angeles CA 90057-3602 Ph: (213) 484-9934 | Isaias De Guzman Paja Jr. Md Inc 1800 Wilshire Blvd Los Angeles CA 90057-3602 Ph: (213) 484-9934 |
| NPI Number | 1053367896 |
|---|---|
| Provider Enumeration Date | 05/25/2006 |
| Last Update Date | 08/23/2024 |
| Medicare PECOS PAC ID | 2264516871 |
|---|---|
| Medicare Enrollment ID | O20080220000701 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053367896 | NPI | - | NPPES |
| 1053367896 | Medicaid | CA | |
| GR 0100110 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (California) | Primary |
| Provider Name | Isaias D Paja |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518997709 PECOS PAC ID: 9931173440 Enrollment ID: I20040820001000 |
| Provider Name | Quang Dao Tran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497269864 PECOS PAC ID: 3476996117 Enrollment ID: I20240208004616 |
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