Organization
CLINICA MEDICA INTERNACIONAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL ERNESTO UMANZOR PA (PA)
(818) 765-4917
Entity
Organization
Contact information
Practice address
7444 LANKERSHIM BLVD, NORTH HOLLYWOOD, CA 91605-2801
(818) 765-4917
(818) 765-0804
Mailing address
7444 LANKERSHIM BLVD, NORTH HOLLYWOOD, CA 91605-2801
(818) 765-4917
(818) 765-0804
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
00A357301
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A357301
—
CA
Enumeration date
11/22/2006
Last updated
01/06/2011
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