Organization
FCS - HIGHLAND PARK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAURICIO EDUARDO BUENO (MEDICAL DIRECTOR)
(323) 791-0557
Entity
Organization
Contact information
Practice address
5823 YORK BLVD, 1, LOS ANGELES, CA 90042-2634
(323) 226-1100
Mailing address
5626 OBERLIN DR STE 110, SAN DIEGO, CA 92121-1705
(323) 317-9200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G77249
CA
332900000X
Non-Pharmacy Dispensing Site
Primary
G77249
CA
Other
Enumeration date
02/25/2008
Last updated
03/31/2026
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