SAN LUCAS MEDICAL CLINIC INC. NPI 1114231354

NPI Information

SAN LUCAS MEDICAL CLINIC, INC. is a general practice in Los Angeles, CA. SAN LUCAS MEDICAL CLINIC, INC. NPI is 1114231354. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2010 WILSHIRE BLVD
SUITE 2012
LOS ANGELES, CA
ZIP 90057-507
Phone: (213) 989-1535
Fax: (213) 989-1843

The provider's authorized official is Vital Hinojosa .
The authorized official title is Medical Director and has the following contact phone number (310) 521-9725.

The CLIA number assigned to this NPI record is 05D2005251 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/29/2010 and was last updated on 5/31/2013.

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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