| San Manuel Medical Clinic,inc | |
|
7400 Pacific Blvd Ste A Walnut Park CA 90255-5739 | |
| (323) 585-8881 | |
| Not Available |
| Full Name | San Manuel Medical Clinic,inc |
|---|---|
| Speciality | Specialist |
| Location | 7400 Pacific Blvd Ste A, Walnut Park, California |
| Authorized Official Name and Position | Elia Webb (OFFICE MANAGER) |
| Authorized Official Contact | 3235858881 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Manuel Medical Clinic,inc 7400 Pacific Blvd Ste A Walnut Park CA 90255-5739 Ph: (323) 585-8881 | San Manuel Medical Clinic,inc 7400 Pacific Blvd Ste A Walnut Park CA 90255-5739 Ph: (323) 585-8881 |
| NPI Number | 1831456482 |
|---|---|
| Provider Enumeration Date | 04/20/2012 |
| Last Update Date | 04/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831456482 | NPI | - | NPPES |
| GR0100930 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 174400000X | Specialist | A84082 (California) | Primary |
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