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.
Organization
LOS REYES MEDICAL CLINIC, INC
Active
Organization
LOS REYES MEDICAL CLINIC, INC
Active
Other names
LOS HERMANOS MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
WINDGROVE DAVID DANIEL M.D. (MEDICAL DIRECTOR/ PRESIDENT)
(323) 583-0450
Entity
Organization
Contact information
Practice address
2715 SANTA ANA ST, SOUTH GATE, CA 90280-2021
(323) 583-0450
(323) 583-0019
Mailing address
2715 SANTA ANA ST, SOUTH GATE, CA 90280-2021
(323) 583-0450
(323) 583-0019
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A41152
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MEDI-CAL
—
CA
Enumeration date
10/31/2006
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up