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LUIS A. GALDAMEZ MD INC. NPI 1225168024


NPI Information

NPI: 1225168024
Provider Name: LUIS A. GALDAMEZ, MD INC.

Doing Business As: CLINICA MEDICA VIRGEN DE GUADALUPE

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 05D0876177

Address:
2955 E FLORENCE AVE
HUNTINGTON PARK, CA
ZIP 90255
Phone: (323) 585-0732
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LUIS A. GALDAMEZ, MD INC. is a pediatrics in Huntington Park, CA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. LUIS A. GALDAMEZ, MD INC. NPI is 1225168024. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Clinica Medica Virgen De Guadalupe.

The provider's business location address is:

2955 E FLORENCE AVE
HUNTINGTON PARK, CA
ZIP 90255-836
Phone: (323) 585-0732
Fax: (323) 585-1673

The provider's authorized official is Corina Ayers .
The authorized official title is Administrator and has the following contact phone number (323) 585-0732.

The CLIA number assigned to this NPI record is 05D0876177 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/7/2007 and was last updated on 8/22/2020.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsA050144CALIFORNIAYes
2208D00000XGeneral PracticeA048644CALIFORNIAX
3363A00000XPhysician AssistantPA17148CALIFORNIAX
4363A00000XPhysician AssistantPA12501CALIFORNIAX
5363A00000XPhysician AssistantPA15773CALIFORNIAX

Other Identifiers

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

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GR0067940MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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