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Organization
GAGE MEDICAL CLINIC INC
Active
Organization
GAGE MEDICAL CLINIC INC
Active
Other names
PACOIMA MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
ODILIA WALSH ADMINISTRATOR (ADMINISTRATOR)
(562) 706-2433
Entity
Organization
Contact information
Practice address
13563 VAN NUYS BLVD, PACOIMA, CA 91331-3029
(818) 890-5300
(818) 890-0880
Mailing address
13563 VAN NUYS BLVD, PACOIMA, CA 91331-3029
(818) 890-5300
(818) 890-0880
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A47748
CA
207Q00000X
Family Medicine Physician
G29047
CA
207V00000X
Obstetrics & Gynecology Physician
A67946
CA
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
02/25/2007
Last updated
02/09/2024
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