# LATINOCARE PARTNERS MEDICAL GROUP

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

## Provider details

- **NPI number:** 1942586136
- **Authorized official:** DR. KANAN MODI M.D. (PRESIDENT)
- **Authorized official phone:** (323) 455-3675

## Contact information

- **Practice address:** 1336 W WHITTIER BLVD, SUITE B, MONTEBELLO, CA 90640-4601
- **Practice address phone:** (323) 455-3995
- **Mailing address:** 4741 E CESAR E CHAVEZ AVE, SUITE B, LOS ANGELES, CA 90022-1209
- **Mailing address phone:** (323) 455-3675

## Taxonomy

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

## Other

- **Enumeration date:** 11/01/2011
- **Last updated:** 11/01/2011