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Organization
CONSULTORIO MEDICO LATINO MEDICAL CENTER
Active
Organization
CONSULTORIO MEDICO LATINO MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BEHROOZ BRUCE YAGOOBIAN MD (PRESIDENT)
(562) 634-1000
Entity
Organization
Contact information
Practice address
15730 PARAMOUNT BLVD, PARAMOUNT, CA 90723-4333
(562) 634-1000
(562) 634-3048
Mailing address
PO BOX 829, PARAMOUNT, CA 90723-0829
(562) 634-1000
(562) 634-3048
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A48328
CA
208000000X
Pediatrics Physician
A48328
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0108328
PIN
CA
05
—
GR0067270
—
CA
Enumeration date
07/02/2006
Last updated
03/30/2015
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