LA LIBERTAD MEDICAL CLINIC INC NPI 1073791828

NPI Information

LA LIBERTAD MEDICAL CLINIC INC is a general practice in South Gate, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee LA LIBERTAD MEDICAL CLINIC INC NPI is 1073791828. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

8427 LONG BEACH BLVD
SOUTH GATE, CA
ZIP 90280-014
Phone: (323) 585-2486
Fax: (562) 943-7518

The provider's authorized official is Ricardo E Chambi .
The authorized official title is President and has the following contact phone number (323) 585-2486.

The CLIA number assigned to this NPI record is 05D0918737 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/4/2008 and was last updated on 3/9/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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