Organization
LA CLINICA DEL PUEBLO
Active
Organization
LA CLINICA DEL PUEBLO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANIE CLEMENT RODRICK (CHIEF FINANCIAL OFFICER)
(202) 464-0141
Entity
Organization
Contact information
Practice address
3166 MOUNT PLEASANT ST NW, WASHINGTON, DC 20010
(202) 462-4788
(202) 667-3706
Mailing address
2831 15TH STREET NW, WASHINGTON, DC 20009
(202) 462-4788
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
52194XXXX650001047
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85518500
—
DC
Enumeration date
09/16/2016
Last updated
09/23/2021
Update your record
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