Organization
CONSULTORIO MEDICO LATINO MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BEHROOZ BRUCE YAGOOBIAN MD (PRESIDENT)
(562) 634-1000
Entity
Organization
Contact information
Practice address
15730 PARAMOUNT BLVD, PARAMOUNT, CA 90723-4333
(562) 634-1000
(562) 634-3048
Mailing address
PO BOX 829, PARAMOUNT, CA 90723-0829
(562) 634-1000
(562) 634-3048
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A48328
CA
208000000X
Pediatrics Physician
A48328
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0108328
PIN
CA
05
—
GR0067270
—
CA
Enumeration date
07/02/2006
Last updated
03/30/2015
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