Organization
SAN LUCAS MEDICAL CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VITAL HINOJOSA M. D. (MEDICAL DIRECTOR & OWNER)
(213) 989-1535
Entity
Organization
Contact information
Practice address
13939 SAN ANTONIO DR, NORWALK, CA 90650-4036
(213) 989-1535
(888) 882-7876
Mailing address
13939 SAN ANTONIO DR, NORWALK, CA 90650-4036
(213) 989-1535
(888) 882-7876
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A37463
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396874202
—
CA
01
—
ED251A
MEDICARE PTAN
CA
Enumeration date
12/23/2013
Last updated
12/23/2013
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