# CLINICA EL LAGO INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CLINICA EL LAGO Inc, Clinica el Lago
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386077857
- **Authorized official:** MR. MARIO A OCHOA MD (OWNER/MEDICAL DIRECTOR)
- **Authorized official phone:** (559) 564-1100

## Contact information

- **Practice address:** 101 N PALM ST, WOODLAKE, CA 93286-1422
- **Practice address phone:** (559) 564-1100
- **Practice address fax:** (559) 564-1101
- **Mailing address:** 101 N PALM ST, WOODLAKE, CA 93286-1422
- **Mailing address phone:** (559) 564-1100
- **Mailing address fax:** (559) 564-1101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | A76417 | CA | Yes |

## Other

- **Enumeration date:** 08/19/2013
- **Last updated:** 07/21/2022