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YORK GLEN MEDICAL CLINIC INC NPI 1265686117


NPI Information

NPI: 1265686117
Provider Name: YORK GLEN MEDICAL CLINIC, INC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
5417 YORK BLVD
LOS ANGELES, CA
ZIP 90042
Phone: (323) 254-2811
Get Directions

YORK GLEN MEDICAL CLINIC, INC is a family medicine in Los Angeles, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. YORK GLEN MEDICAL CLINIC, INC NPI is 1265686117. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5417 YORK BLVD
LOS ANGELES, CA
ZIP 90042-401
Phone: (323) 254-2811
Fax: (323) 254-1788

The provider's authorized official is Ador A Bustamante .
The authorized official title is Owner and has the following contact phone number (323) 254-2811.

The enumeration date for this NPI number is 11/5/2008 and was last updated on 7/22/2013.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineA54189CALIFORNIAYes

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
1AU897MEDICARE PINCALIFORNIA

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

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