San Blas Medical Clinic

NPI #1982035069 in Stanton, California

Provider Information

NPI Number: 1982035069
Entity Type: Organization
Organization Name: San Blas Medical Clinic
Subpart: Yes (part of a larger organization)
Parent Organization: SAN BLAS MEDICAL CLINIC
Primary Specialty: General Practice
Enumeration Date: Nov 27, 2013
Last Updated: Nov 27, 2013

Practice Location

Address: 7777 KATELLA AVENUE
City: Stanton
State: California
ZIP Code: 90680
Phone: (714) 220-2223

Authorized Official

Name: MR. JESUS MANUEL FRAUSTO SR., MD
Title: PRESIDENT
Phone: (714) 220-2223

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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