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Organization
MISSION SAN JUAN MEDICAL CLINIC
Active
Organization
MISSION SAN JUAN MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOEL JR TORRES MD (MEDICAL DIRECTOR)
(323) 564-1100
Entity
Organization
Contact information
Practice address
9914 SAN JUAN AVE, SOUTH GATE, CA 90280-6108
(323) 564-1100
Mailing address
9914 SAN JUAN AVE, SOUTH GATE, CA 90280-6108
(323) 564-1100
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A93526
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A93526
CA MEDICAL LICENSE
CA
Enumeration date
07/02/2008
Last updated
07/02/2008
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