Organization
CLINICA MEDICA SAN MIGUEL IPA, A MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAN N PHAM MPH (ADMINISTRATOR)
(626) 656-2370
Entity
Organization
Contact information
Practice address
2360 HUNTINGTON DR STE 201, SAN MARINO, CA 91108-2651
(626) 656-2370
(626) 248-9060
Mailing address
2360 HUNTINGTON DR STE 201, SAN MARINO, CA 91108-2651
(626) 656-2370
(626) 248-9060
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
09/13/2007
Last updated
09/13/2007
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