Organization
ERNESTO L. FONTECHA, MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERNESTO FONTECHA MD (CEO)
(213) 388-2044
Entity
Organization
Contact information
Practice address
159 S VERMONT AVE, LOS ANGELES, CA 90004-5904
(213) 388-2044
(213) 632-0140
Mailing address
159 S VERMONT AVE, LOS ANGELES, CA 90004-5904
(213) 388-2044
(213) 632-0140
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A36618
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A36618
MEDICAL LICENSE
CA
Enumeration date
01/13/2016
Last updated
11/27/2017
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