# SAN MARTIN DE PORRES MEDICAL CLINIC INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215953609
- **Authorized official:** FRANCISCO EDGARDO PAREDES M.D. (OWNER)
- **Authorized official phone:** (562) 654-6855

## Contact information

- **Practice address:** 9315 TELEGRAPH RD, PICO RIVERA, CA 90660-5424
- **Practice address phone:** (562) 654-6855
- **Practice address fax:** (562) 654-6856
- **Mailing address:** 9315 TELEGRAPH RD, PICO RIVERA, CA 90660-5424
- **Mailing address phone:** (562) 654-6855
- **Mailing address fax:** (562) 654-6856

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A24482 | CA | Yes |

## Other

- **Enumeration date:** 07/15/2006
- **Last updated:** 01/20/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZZ80011Z | — | CA |