Organization
LOS ANGELES CLINICA MEDICA GENERAL MEDICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSE LUIS CARRILLO JR. (BUSINESS ACCOUNTS MANAGER)
(213) 739-3282
Entity
Organization
Contact information
Practice address
2208 W 7TH ST, LOS ANGELES, CA 90057-4002
(213) 384-3434
(213) 386-2039
Mailing address
PO BOX 10432, BEVERLY HILLS, CA 90213-3432
(213) 637-2530
(231) 384-3373
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0076110
—
CA
Enumeration date
05/28/2006
Last updated
07/31/2020
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