| NPI | 1255318630 |
|---|---|
| Doing Business As | EASTSIDE MEDICAL CARE CENTER, PA |
| Entity Type | Organization |
| Authorized Contact | LAURENCE JUAREZ Administrator 915-842-0504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2012-12-19 |