Organization
LA CLINICA DE LA RAZA, INC.
Active
Parent organization
LA CLINICA DE LA RAZA, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
LA CLINICA DE LA RAZA, INC.
Authorized official
MRS. SUSAN MOORE (CFO)
(510) 535-2915
Entity
Organization
Contact information
Practice address
1030 INTERNATIONAL BLVD, OAKLAND, CA 94606-3730
(510) 238-5400
(510) 238-8015
Mailing address
PO BOX 22210, OAKLAND, CA 94623-2322
(510) 535-4000
(510) 535-4189
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0500941
—
CA
Enumeration date
07/06/2011
Last updated
06/08/2020
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