# GOLDEN EAGLE MEDICAL NETWORK

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CLINICA MEDICA SAN PEDRO NETWORK
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255697736
- **Authorized official:** JACINTO LAM MD (PRESIDENT)
- **Authorized official phone:** (626) 960-6666

## Contact information

- **Practice address:** 1025 N WILLOW AVE, LA PUENTE, CA 91746-1617
- **Practice address phone:** (626) 960-6666
- **Practice address fax:** (626) 960-5666
- **Mailing address:** 1025 N WILLOW AVE, LA PUENTE, CA 91746-1617
- **Mailing address phone:** (626) 960-6666
- **Mailing address fax:** (626) 960-5666

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | A 39722 | CA | Yes |

## Other

- **Enumeration date:** 04/09/2012
- **Last updated:** 04/09/2012