| NPI | 1164119970 |
|---|---|
| Former Legal Business Name | CLINICA NUEVA VIDA MEDICAL INC |
| Entity Type | Organization |
| Authorized Contact | HERMAN FRICKE CARRILLO Md/CEO 818-847-1007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-04-20 |
| Last Update Date | 2023-04-20 |