Organization
LA PAZ MEDICAL CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD BERTON MANTELL MD (OWNER)
(626) 359-8604
Entity
Organization
Contact information
Practice address
1345 HUNTINGTON DR, DUARTE, CA 91010-2527
(626) 359-8604
Mailing address
1345 HUNTINGTON DR, DUARTE, CA 91010-2527
(626) 359-8604
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A39992
CA
Other
Enumeration date
08/29/2013
Last updated
08/29/2013
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