Organization · NPI-2

Baldwin Park Medical Clinic INC

Family Medicine · Baldwin Park, CA

NPI number1750728663
StatusActive
Last updated in NPPESApr 23, 2020

Details

NPI
1750728663
Entity type
Organization (NPI-2)
Legal business name
Baldwin Park Medical Clinic INC
Organization subpart
No
Enumeration date
May 31, 2013
Certification date
Apr 23, 2020
Last updated
Apr 23, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes
174400000X SpecialistG62452CA

Practice location

14051 Ramona Pkwy
Baldwin Park, CA 91706-4114

Phone 626-960-3753 · Fax 626-962-9866

Mailing address

14051 Ramona Pkwy
Baldwin Park, CA 91706-4114

Phone 626-960-3753 · Fax 626-962-9866

Authorized official

Terry M Lee
President
6269603753

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