Organization
EASTSIDE FAMILY MEDICAL ASSOCIATES, INC.
Active
Other names
Eastside Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ENRIQUE J. GONZALEZ M.D. (PRESIDENT)
(323) 261-4706
Entity
Organization
Contact information
Practice address
321 S MEDNIK AVE, LOS ANGELES, CA 90022-1839
(323) 261-4706
(323) 261-4124
Mailing address
321 S MEDNIK AVE, LOS ANGELES, CA 90022-1839
(323) 261-4706
(323) 262-6874
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
G74790
CA
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G747901
—
CA
Enumeration date
08/30/2007
Last updated
03/29/2022
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