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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)
(323) 791-0557
Entity
Organization
Contact information
Practice address
1701 E CESAR CHAVEZ AVENUE, SUITE 230, LOS ANGELES, CA 90033-2464
(323) 317-9200
(323) 226-1101
Mailing address
5823 YORK BLVD STE 1, LOS ANGELES, CA 90042-2634
(323) 317-9200
(323) 255-2158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CQ2165
MEDICARE RAILROAD GROUP
GA
01
—
GR0040670
MEDICAID GROUP ID
CA
01
—
W10759
MEDICARE GROUP ID
CA
01
—
ZZZ22102Z
BLUE SHIELD GROUP ID
CA
Enumeration date
05/24/2006
Last updated
04/07/2026
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