Organization
CLINICA MEDICA LA ESPERANZA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REYNALDO QUINONEZ PA-C (PRESIDENT / CEO)
(323) 560-1100
Entity
Organization
Contact information
Practice address
4207 SLAUSON AVE, MAYWOOD, CA 90270-2835
(323) 560-1100
(323) 560-1333
Mailing address
4207 SLAUSON AVE, MAYWOOD, CA 90270-2835
(323) 560-1100
(323) 560-1333
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20A7810
CA
207RN0300X
Nephrology Physician
Primary
20A7810
CA
363AM0700X
Medical Physician Assistant
PA17156
CA
363AM0700X
Medical Physician Assistant
PA19411
CA
Other
Enumeration date
04/01/2010
Last updated
11/29/2010
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