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Organization
NOGALES MEDICAL CLINIC, INC
Active
Organization
NOGALES MEDICAL CLINIC, INC
Active
Other names
Nogales Medical Clinic, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LORENZO M VAZQUEZ M.D (PRESIDENT/CEO)
(626) 931-6618
Entity
Organization
Contact information
Practice address
1840 N HACIENDA BLVD STE 10, LA PUENTE, CA 91744-1143
(626) 931-6618
(626) 931-6610
Mailing address
1840 N HACIENDA BLVD STE 10, LA PUENTE, CA 91744-1143
(626) 931-6618
(626) 931-6610
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
A70384
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A703840
—
CA
Enumeration date
03/15/2007
Last updated
04/12/2021
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