# EAST WEST BARUCH MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clinica Angel de Su Salud
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588098842
- **Authorized official:** DR. ADEL BOUTROS MD (PRESIDENT)
- **Authorized official phone:** (323) 370-7430

## Contact information

- **Practice address:** 4811 E FLORENCE AVE, BELL, CA 90201
- **Practice address phone:** (213) 472-6651
- **Mailing address:** 2661 E FLORENCE AVE SUITE B, HUNTINGTON PARK, CA 90255
- **Mailing address phone:** (213) 472-6651

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |
| 213E00000X | Podiatrist | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | — |

## Other

- **Enumeration date:** 08/22/2013
- **Last updated:** 05/11/2021