| NPI | 1124101985 |
|---|---|
| Former Legal Business Name | EASTLAKE FAMILY MEDICAL INC. |
| Entity Type | Organization |
| Authorized Contact | MARIA DE LOS ANGELES OSEGUERA President 619-946-4073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A 6433) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2014-06-05 |