# CONSULTORIO MEDICO HISPANO

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1497205991
- **Authorized official:** ANTONIO MOLINA (BUSINESS MANAGER)
- **Authorized official phone:** (678) 557-8292

## Contact information

- **Practice address:** 3182 SHALLOWFORD RD NE, CHAMBLEE, GA 30341-3640
- **Practice address phone:** (678) 557-8292
- **Mailing address:** 3182 SHALLOWFORD RD NE, CHAMBLEE, GA 30341-3640

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | RN220493 | GA | Yes |

## Other

- **Enumeration date:** 10/07/2016
- **Last updated:** 10/07/2016