Organization
CLINICA SANTA MARTA MEDICAL GROUP
Active
Parent organization
MEDVANTX, INC
Other names
Clinica Santa Marta
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
3742 WHITTIER BLVD, LOS ANGELES, CA 90023-1704
(323) 780-4100
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
PA19472
CA
Other
Enumeration date
08/15/2013
Last updated
08/15/2013
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