| Sin Fronteras Health And Wellness Center, Inc, A Professional Corporat | |
|
6006 Whittier Blvd Los Angeles CA 90022-4402 | |
| (323) 725-6292 | |
| (323) 725-6292 |
| Full Name | Sin Fronteras Health And Wellness Center, Inc, A Professional Corporat |
|---|---|
| Speciality | General Practice |
| Location | 6006 Whittier Blvd, Los Angeles, California |
| Authorized Official Name and Position | Raul Lopez (CEO/ PRESIDENT) |
| Authorized Official Contact | 3237256292 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sin Fronteras Health And Wellness Center, Inc, A Professional Corporat 6006 Whittier Blvd Los Angeles CA 90022-4402 Ph: (323) 725-6292 | Sin Fronteras Health And Wellness Center, Inc, A Professional Corporat 6006 Whittier Blvd Los Angeles CA 90022-4402 Ph: (323) 725-6292 |
| NPI Number | 1114560083 |
|---|---|
| Provider Enumeration Date | 10/23/2019 |
| Last Update Date | 12/14/2020 |
| Medicare PECOS PAC ID | 8022427798 |
|---|---|
| Medicare Enrollment ID | O20210510001462 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114560083 | NPI | - | NPPES |
| 00G733840 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Jose M Diaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427078781 PECOS PAC ID: 9032009329 Enrollment ID: I20040318001739 |
| Provider Name | Raul Lopez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124089701 PECOS PAC ID: 0446232524 Enrollment ID: I20040602001424 |
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