CLINICA SANTA MARTA MEDICAL GROUP NPI 1417380254

NPI Information

CLINICA SANTA MARTA MEDICAL GROUP is a non pharmacy dispensing site in Los Angeles, CA. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) CLINICA SANTA MARTA MEDICAL GROUP NPI is 1417380254. The provider is registered as an organization entity type.
The provider Is Doing Business As Clinica Santa Marta.

The provider's business location address is:

3742 WHITTIER BLVD
LOS ANGELES, CA
ZIP 90023-704
Phone: (323) 780-4100

The provider's authorized official is Kenny Heine .
The authorized official title is Vp Of Operations and has the following contact phone number (858) 964-1506.

The CLIA number assigned to this NPI record is 05D1091450 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/15/2013 and was last updated on 8/15/2013.

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:

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