San Gabriel Pediatrics Medical Corporation

NPI #1962400028 in Los Angeles, California

Provider Information

NPI Number: 1962400028
Entity Type: Organization
Organization Name: San Gabriel Pediatrics Medical Corporation
Primary Specialty: Clinic/Center
Enumeration Date: Jul 12, 2005
Last Updated: Mar 2, 2010

Practice Location

Address: 3450 W 43RD ST
Address 2: SUITE 107
City: Los Angeles
State: California
ZIP Code: 90008-4943
Phone: (323) 290-2832

Authorized Official

Name: DR. MEZIA OGUGUA AZINGE-OBASI, M.D.
Title: PRESIDENT/CEO
Phone: (323) 290-2832

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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