Organization
PRIMA VIDA MEDICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELEANOR VERZOSA AZURIN M.D. (PRESIDENT)
(562) 923-8300
Entity
Organization
Contact information
Practice address
8706 IMPERIAL HWY, DOWNEY, CA 90242-3906
(562) 923-8300
Mailing address
8706 IMPERIAL HWY, DOWNEY, CA 90242-3906
(562) 923-8300
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A66742
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407143464
—
CA
Enumeration date
06/28/2011
Last updated
01/02/2013
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