# MEDICAL CLINIC MANAGEMENT

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

## Provider details

- **NPI number:** 1861849267
- **Authorized official:** RODRIGO COVARRUBIAS M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (714) 648-0503

## Contact information

- **Practice address:** 1125 E 17TH ST STE W237, SANTA ANA, CA 92701-2205
- **Practice address phone:** (714) 648-0503
- **Practice address fax:** (714) 648-0539
- **Mailing address:** 1125 E 17TH ST STE W237, SANTA ANA, CA 92701-2205
- **Mailing address phone:** (714) 648-0503
- **Mailing address fax:** (714) 648-0539

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/16/2016
- **Last updated:** 05/16/2016