# LOURDES G BAHAMONDE DO INC

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

## Provider details

- **NPI number:** 1609533587
- **Authorized official:** DR. LOURDES G BAHAMONDE D.O. (CEO)
- **Authorized official phone:** (516) 526-9192

## Contact information

- **Practice address:** 7643 ATLANTIC AVE, CUDAHY, CA 90201-5019
- **Practice address phone:** (213) 373-1265
- **Mailing address:** 147 N MAYFLOWER AVE, MONROVIA, CA 91016-2005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | — | — |

## Other

- **Enumeration date:** 11/26/2021
- **Last updated:** 11/30/2021