| St. Anne Medical Clinic, Pc | |
|
2536 W Temple St. Los Angeles CA 90026-4848 | |
| (213) 385-7888 | |
| (213) 385-7887 |
| Full Name | St. Anne Medical Clinic, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2536 W Temple St., Los Angeles, California |
| Authorized Official Name and Position | Anna Lourdes Armada Chickey (PRESIDENT) |
| Authorized Official Contact | 5629000379 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Anne Medical Clinic, Pc 2536 W Temple St. Los Angeles CA 90026-4848 Ph: (213) 385-7888 | St. Anne Medical Clinic, Pc 2536 W Temple St. Los Angeles CA 90026-4848 Ph: (213) 385-7888 |
| NPI Number | 1194904482 |
|---|---|
| Provider Enumeration Date | 11/02/2007 |
| Last Update Date | 01/19/2011 |
| Medicare PECOS PAC ID | 6901868264 |
|---|---|
| Medicare Enrollment ID | O20041028001084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194904482 | NPI | - | NPPES |
| 00A519920 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A051992 (California) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | A51992 (California) | Primary |
| Provider Name | Anna Chickey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609972207 PECOS PAC ID: 7810959186 Enrollment ID: I20041028001111 |
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