# NUESTRA CLINICA, INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1588808547
- **Authorized official:** GREGORY B JAHANGIRI D.O. (PRESIDENT, CO-OWNER)
- **Authorized official phone:** (323) 264-2890

## Contact information

- **Practice address:** 4477 WHITTIER BLVD, LOS ANGELES, CA 90022-1535
- **Practice address phone:** (323) 264-2890
- **Practice address fax:** (323) 268-2515
- **Mailing address:** 4477 WHITTIER BLVD, LOS ANGELES, CA 90022-1535
- **Mailing address phone:** (323) 264-2890
- **Mailing address fax:** (323) 268-2515

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 20A5721 | CA | Yes |

## Other

- **Enumeration date:** 04/21/2009
- **Last updated:** 04/28/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1558587360 | MEDI-CAL | CA |
| 01 | — | 1689854986 | MEDI-CAL | CA |
| 01 | — | 1851553804 | MEDICAL | CA |