# CLINICA DEL PUEBLO

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

## Provider details

- **NPI number:** 1710160049
- **Authorized official:** EARLA E QUISIDO MD (OWNER)
- **Authorized official phone:** (661) 845-2399

## Contact information

- **Practice address:** 10200 MAIN ST, LAMONT, CA 93241-1700
- **Practice address phone:** (661) 845-2399
- **Practice address fax:** (661) 845-1791
- **Mailing address:** 10200 MAIN ST, LAMONT, CA 93241-1700
- **Mailing address phone:** (661) 845-2399
- **Mailing address fax:** (661) 845-1791

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A48100 | CA | Yes |

## Other

- **Enumeration date:** 12/10/2007
- **Last updated:** 01/29/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00A481000 | — | CA |