| Shalom Medical Clinic | |
|
1721 N Wilmington Blvd Wilmington CA 90744-1261 | |
| (310) 835-1414 | |
| (310) 835-4050 |
| Full Name | Shalom Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1721 N Wilmington Blvd, Wilmington, California |
| Authorized Official Name and Position | Angel G Perez (OWNER) |
| Authorized Official Contact | 3108351414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shalom Medical Clinic 1721 N Wilmington Blvd Wilmington CA 90744-1261 Ph: (310) 835-1414 | Shalom Medical Clinic 1721 N Wilmington Blvd Wilmington CA 90744-1261 Ph: (310) 835-1414 |
| NPI Number | 1295940054 |
|---|---|
| Provider Enumeration Date | 05/14/2007 |
| Last Update Date | 06/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295940054 | NPI | - | NPPES |
| 00G793480 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G79348 (California) | Primary |
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