Organization
SAN BLAS MEDICAL CLINIC
Active
Parent organization
SAN BLAS MEDICAL CLINIC
Other names
Clinica Medica San Blas
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAN BLAS MEDICAL CLINIC
Authorized official
MR. JESUS MANUEL FRAUSTO SR. MD (PRESIDENT)
(714) 220-2223
Entity
Organization
Contact information
Practice address
7777 KATELLA AVENUE, STANTON, CA 90680
(714) 220-2223
(714) 220-2249
Mailing address
7777 KATELLA AVENUE, STANTON, CA 90680
(714) 220-2223
(714) 220-2249
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A-79043
CA
Other
Enumeration date
11/27/2013
Last updated
11/27/2013
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