# SANTA ROSA DE LIMA MEDICAL CLINIC INC.

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

## Provider details

- **NPI number:** 1821139205
- **Authorized official:** EDWIN ZEVALLOS (PHYSYCIAN)
- **Authorized official phone:** (323) 588-9800

## Contact information

- **Practice address:** 6915 SEVILLE AVE, HUNTINGTON PARK, CA 90255-4901
- **Practice address phone:** (323) 588-9800
- **Mailing address:** 6915 SEVILLE AVENUE, HUNTINGTON PARK, CA 90255
- **Mailing address phone:** (323) 588-9800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A53394 | CA | Yes |

## Other

- **Enumeration date:** 02/09/2007
- **Last updated:** 08/22/2020