San Martin De Porres Medical Clinic of South Gate, INC
NPI #1134298318 in South Gate, California
Provider Information
- NPI Number
- 1134298318
- Entity Type
- Organization
- Organization Name
- San Martin De Porres Medical Clinic of South Gate, INC
- Primary Specialty
- General Practice
- Enumeration Date
- Nov 6, 2006
- Last Updated
- Oct 6, 2014
Practice Location
- Address
- 10001 CALIFORNIA AVE
- City
- South Gate
- State
- California
- ZIP Code
- 90280-6005
- Phone
- (323) 564-4408
Authorized Official
- Name
- MRS. ANA CONSIGLIERI
- Title
- SUPERVISOR
- Phone
- (323) 564-4408
Specialties & Taxonomy Codes
| Specialty |
|---|
| General Practice |
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