San Manuel Medical Clinic,inc

NPI #1831456482 in Walnut Park, California

Provider Information

NPI Number: 1831456482
Entity Type: Organization
Organization Name: San Manuel Medical Clinic,inc
Primary Specialty: Specialist
Enumeration Date: Apr 20, 2012
Last Updated: Apr 20, 2012

Practice Location

Address: 7400 PACIFIC BLVD STE A
City: Walnut Park
State: California
ZIP Code: 90255-5739
Phone: (323) 585-8881

Authorized Official

Name: ELIA WEBB
Title: OFFICE MANAGER
Phone: (323) 585-8881

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Specialist	174400000X	Primary

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