Organization
CLINICA MEDICA SAN PEDRO OF CALIFORNIA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE MANUEL DIAZ MD (PRESIDENT / CEO)
(626) 960-6666
Entity
Organization
Contact information
Practice address
1025 WILLOW AVE, LA PUENTE, CA 91746-1617
(626) 960-6666
(626) 960-5666
Mailing address
1025 WILLOW AVE, LA PUENTE, CA 91746-1617
(626) 960-6666
(626) 960-5666
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
A39722
CA
208000000X
Pediatrics Physician
Primary
A76805
CA
Other
Enumeration date
08/13/2010
Last updated
08/13/2010
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