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Organization
NUESTRA CLINICA, INC
Active
Organization
NUESTRA CLINICA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY B JAHANGIRI D.O. (PRESIDENT, CO-OWNER)
(323) 264-2890
Entity
Organization
Contact information
Practice address
4477 WHITTIER BLVD, LOS ANGELES, CA 90022-1535
(323) 264-2890
(323) 268-2515
Mailing address
4477 WHITTIER BLVD, LOS ANGELES, CA 90022-1535
(323) 264-2890
(323) 268-2515
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
20A5721
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558587360
MEDI-CAL
CA
01
—
1689854986
MEDI-CAL
CA
01
—
1851553804
MEDICAL
CA
Enumeration date
04/21/2009
Last updated
04/28/2017
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