Organization
MANUEL ACEVEDO MEDICAL GROUP, A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETO M ACEVEDO-CARMONA (BUSINESS MANAGER/ADMINISTRATOR)
(213) 637-9080
Entity
Organization
Contact information
Practice address
1830 W OLYMPIC BLVD, STE. 124, LOS ANGELES, CA 90006-3734
(213) 637-9080
(213) 637-9084
Mailing address
1830 W OLYMPIC BLVD, STE. 124, LOS ANGELES, CA 90006-3734
(213) 637-9080
(213) 637-9084
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A74961
CA
Other
Enumeration date
10/24/2007
Last updated
11/26/2007
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