La Paz Medical Clinic, INC
Clinic/Center, Primary Care in Duarte, CA. Organization (NPI-2).
NPI number1124452875
StatusActive
Last updated in NPPESAug 29, 2013
Details
- NPI
- 1124452875
- Entity type
- Organization (NPI-2)
- Legal business name
- La Paz Medical Clinic, INC
- Organization subpart
- No
- Enumeration date
- Aug 29, 2013
- Last updated
- Aug 29, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | A39992 | CA | Yes |
Practice location
1345 Huntington DrDuarte, CA 91010-2527
Phone 626-359-8604
Mailing address
1345 Huntington DrDuarte, CA 91010-2527
Phone 626-359-8604
Authorized official
Richard Berton Mantell
Owner
6263598604
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