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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 MD (CHIEF MEDICAL OFFICER)
(323) 791-0557
Entity
Organization
Contact information
Practice address
815 WASHINGTON BLVD, MONTEBELLO, CA 90640-6123
(323) 317-9200
(323) 728-6905
Mailing address
5823 YORK BLVD STE 3, LOS ANGELES, CA 90042-2634
(323) 317-9200
(323) 254-2158
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
—
GR0040672
MEDICAID GROUP ID
CA
01
—
W10759A
MEDICARE GROUP ID
CA
01
—
ZZZ22101Z
BLUE SHIELD GROUP ID
CA
Enumeration date
05/18/2006
Last updated
03/31/2026
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