SANTA ADELINA MEDICAL CLINIC INC NPI 1508284878

NPI Information

  • NPI: 1508284878
  • Provider Name: SANTA ADELINA MEDICAL CLINIC INC
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • CLIA Number: 05D1036247
  • Address: 680 E ALOSTA AVE
    SUITE 209
    AZUSA, CA
    ZIP 91702
  • Phone: (626) 812-9733

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NPI Details

SANTA ADELINA MEDICAL CLINIC INC is a general practice in Azusa, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee SANTA ADELINA MEDICAL CLINIC INC NPI is 1508284878. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

680 E ALOSTA AVE
SUITE 209
AZUSA, CA
ZIP 91702-705
Phone: (626) 812-9733
Fax: (626) 981-2974

The provider's authorized official is Jorge Velazquez .
The authorized official title is President and has the following contact phone number (626) 812-9733.

The CLIA number assigned to this NPI record is 05D1036247 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/2/2014 and was last updated on 4/2/2014.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral PracticeYes

What is NPI?

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This page was last updated on: 11/21/2025

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