Organization
THE MISSION MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDUARDO DI SARLI MD (OWNER)
(323) 587-7771
Entity
Organization
Contact information
Practice address
3045 E FLORENCE AVE, HUNTINGTON PARK, CA 90255
(323) 587-7771
(323) 587-8310
Mailing address
P.O. BOX 2397, HUNTINGTON PARK, CA 90255
(323) 587-7771
(323) 587-8310
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
A36991
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A36991
CAL LICENSE
CA
05
—
GR0070310
—
CA
Enumeration date
09/21/2006
Last updated
03/07/2023
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