# CLINICA MEDICA LA SAGRADA FAMILIA A PROFESSIONAL MEDICAL CORP

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

## Provider details

- **NPI number:** 1578567038
- **Authorized official:** DR. MARVIN CANLAS TRANI DO (PRESIDENT/CEO)
- **Authorized official phone:** (562) 531-9806

## Contact information

- **Practice address:** 15955 PARAMOUNT BLVD, UNIT A, PARAMOUNT, CA 90723-5144
- **Practice address phone:** (562) 531-9806
- **Practice address fax:** (562) 531-1394
- **Mailing address:** 15955 PARAMOUNT BLVD, UNIT A, PARAMOUNT, CA 90723-5144
- **Mailing address phone:** (562) 531-9806
- **Mailing address fax:** (562) 531-1394

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | A48853 | CA | — |

## Other

- **Enumeration date:** 06/10/2005
- **Last updated:** 06/27/2022