Organization
MISSION SAN JUAN MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOEL JR TORRES MD (MEDICAL DIRECTOR)
(323) 564-1100
Entity
Organization
Contact information
Practice address
9914 SAN JUAN AVE, SOUTH GATE, CA 90280-6108
(323) 564-1100
Mailing address
9914 SAN JUAN AVE, SOUTH GATE, CA 90280-6108
(323) 564-1100
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A93526
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A93526
CA MEDICAL LICENSE
CA
Enumeration date
07/02/2008
Last updated
07/02/2008
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