San Manuel Medical Clinic Inc.

NPI #1194071225 in Walnut Park, California

Provider Information

NPI Number: 1194071225
Entity Type: Organization
Organization Name: San Manuel Medical Clinic Inc.
Primary Specialty: Specialist
Enumeration Date: Jul 26, 2012
Last Updated: Jul 26, 2012

Practice Location

Address: 7400 PACIFIC BLVD
Address 2: STE A
City: Walnut Park
State: California
ZIP Code: 90255-5739
Phone: (323) 584-8881

Authorized Official

Name: DR. ANJANA SURA, M.D.
Title: DIRECTOR
Phone: (323) 584-8881

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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