# SANTA ADELINA MEDICAL CLINIC INC

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

## Provider details

- **NPI number:** 1508284878
- **Authorized official:** JORGE VELAZQUEZ PA-C (PRESIDENT)
- **Authorized official phone:** (626) 812-9733

## Contact information

- **Practice address:** 680 E ALOSTA AVE, SUITE 209, AZUSA, CA 91702-2705
- **Practice address phone:** (626) 812-9733
- **Practice address fax:** (626) 981-2974
- **Mailing address:** 680 E ALOSTA AVE, SUITE 209, AZUSA, CA 91702-2705
- **Mailing address phone:** (626) 812-9733
- **Mailing address fax:** (626) 981-2974

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/02/2014
- **Last updated:** 04/02/2014