Organization
CLINICA MEDICA DE LA MORA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSCAR MANUEL DE LA MORA M.D. (OWNER)
(619) 264-3107
Entity
Organization
Contact information
Practice address
995 GATEWAY CENTER WAY, SUITE 202, SAN DIEGO, CA 92102-4500
(619) 264-3107
(619) 264-6927
Mailing address
995 GATEWAY CENTER WAY, SUITE 202, SAN DIEGO, CA 92102-4500
(619) 264-3107
(619) 264-6927
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A30061
CA
207R00000X
Internal Medicine Physician
Primary
C50916
CA
208000000X
Pediatrics Physician
A50769
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A050769
—
CA
Enumeration date
05/13/2010
Last updated
05/13/2010
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