Organization
PICO CLINICA MEDICA LATINA, A MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERESITA ALONZO ZARENO MD (VICE PRESIDENT)
(213) 386-5252
Entity
Organization
Contact information
Practice address
1600 W PICO BLVD, LOS ANGELES, CA 90015-2410
(213) 386-5252
(213) 386-5323
Mailing address
1600 W PICO BLVD, LOS ANGELES, CA 90015-2410
(213) 386-5252
(213) 386-5323
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
A39524
CA
208D00000X
General Practice Physician
Primary
A40110
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0082120
—
CA
Enumeration date
02/05/2007
Last updated
12/09/2009
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