Organization
CLINICA DE LA SALUD HISPANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDGAR MIGUEL VELEZ M.A. (OFFICE MANAGER)
(770) 451-0662
Entity
Organization
Contact information
Practice address
3652 CHAMBLEE DUNWOODY RD, SUITE 4, CHAMBLEE, GA 30341-2120
(770) 451-0662
(770) 451-0214
Mailing address
3652 CHAMBLEE DUNWOODY RD, SUITE 4, CHAMBLEE, GA 30341-2120
(770) 451-0662
(770) 451-0214
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
011821
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
229152370A
—
GA
Enumeration date
11/07/2006
Last updated
10/17/2008
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