Organization
EASTSIDE FAMILY MEDICAL ASSOCIATES, INC.
Active
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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