Provider Type Icon

SAN MANUEL MEDICAL CLINICINC NPI 1831456482


NPI Information

NPI: 1831456482
Provider Name: SAN MANUEL MEDICAL CLINIC,INC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
7400 PACIFIC BLVD STE A
WALNUT PARK, CA
ZIP 90255
Phone: (323) 585-8881
Get Directions

SAN MANUEL MEDICAL CLINIC,INC is a specialist in Walnut Park, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SAN MANUEL MEDICAL CLINIC,INC NPI is 1831456482. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

7400 PACIFIC BLVD STE A
WALNUT PARK, CA
ZIP 90255-739
Phone: (323) 585-8881

The provider's authorized official is Elia Webb .
The authorized official title is Office Manager and has the following contact phone number (323) 585-8881.

The enumeration date for this NPI number is 4/20/2012 and was last updated on 4/20/2012.


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
1207Q00000XFamily MedicineNo
2174400000XSpecialistA84082CALIFORNIAYes

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
1A84082MEDICARE UPINCALIFORNIA
2GR0100930MEDICAIDCALIFORNIA

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.