Organization
CLINICA MSR. OSCAR ROMERO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL HENRY GIBONEY M.D. (PHYSICIAN)
(323) 987-1401
Entity
Organization
Contact information
Practice address
2032 MARENGO ST, LOS ANGELES, CA 90033-1319
(323) 987-1401
Mailing address
123 S ALVARADO ST, LOS ANGELES, CA 90057-2201
(323) 987-1413
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
A067450
CA
Other
Enumeration date
09/11/2008
Last updated
09/11/2008
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