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Organization
FAMILY CARE SPECIALISTS MEDICAL CORPORATION
Active
Organization
FAMILY CARE SPECIALISTS MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAURICIO EDUARDO BUENO (MEDICAL GROUP DIRECTOR)
(323) 791-0557
Entity
Organization
Contact information
Practice address
1701 E CESAR CHAVEZ AVENUE, SUITE 402, LOS ANGELES, CA 90033-2496
(323) 317-9200
(323) 317-9206
Mailing address
5823 YORK BLVD STE 3, LOS ANGELES, CA 90042-2634
(323) 317-9200
(323) 317-9206
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CQ2165
RAILROAD MEDICARE GROUP
GA
01
—
GR0040674
MEDICAID GROUP ID
CA
01
—
ZZZ56170Z
BLUE SHIELD GROUP ID
CA
Enumeration date
05/18/2006
Last updated
03/31/2026
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