| NPI | 1225168024 |
|---|---|
| Doing Business As | CLINICA MEDICA VIRGEN DE GUADALUPE |
| Entity Type | Organization |
| Authorized Contact | CORINA AYERS Administrator 323-585-0732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA15773) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A050144) |
| 208D00000X General Practice (Licence: CA A048644) | |
| 363A00000X Physician Assistant (Licence: CA PA17148) | |
| 363A00000X Physician Assistant (Licence: CA PA12501) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2025-09-11 |