Organization
LA CLINICA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EBRAHIM DUEL M.D. (PHYSICIAN)
(714) 547-6641
Entity
Organization
Contact information
Practice address
1400 W MCFADDEN AVE STE 4, SANTA ANA, CA 92704-3438
(714) 546-8200
(714) 546-8755
Mailing address
1400 W MCFADDEN AVE STE 4, SANTA ANA, CA 92704-3438
(714) 546-8200
(714) 546-8755
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A33882
CA
174400000X
Specialist
C50959
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A338823
—
CA
Enumeration date
02/25/2008
Last updated
03/07/2023
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