# CLINICA SANTA MARTA MEDICAL GROUP, INC

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

## Provider details

- **NPI number:** 1366699027
- **Authorized official:** MR. VICTOR M QUINONES (OFFICE MANAGER)
- **Authorized official phone:** (323) 780-4100

## Contact information

- **Practice address:** 3742 WHITTIER BLVD, LOS ANGELES, CA 90023-1704
- **Practice address phone:** (323) 780-4100
- **Practice address fax:** (323) 780-4110
- **Mailing address:** 3742 WHITTIER BLVD, LOS ANGELES, CA 90023-1704
- **Mailing address phone:** (323) 780-4100
- **Mailing address fax:** (323) 780-4110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A99511 | CA | Yes |

## Other

- **Enumeration date:** 08/25/2008
- **Last updated:** 03/10/2016