CLINICA MEDICA DOCTOR VIZCARRA NPI 1629405964

NPI Information

NPI: 1629405964
Provider Name: CLINICA MEDICA DOCTOR VIZCARRA
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 11D2069050

Address:
6825 JIMMY CARTER BLVD
SUITE 1590
NORCROSS, GA
ZIP 30071
Phone: (678) 615-2565
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CLINICA MEDICA DOCTOR VIZCARRA is a primary care clinic center in Norcross, GA. CLINICA MEDICA DOCTOR VIZCARRA NPI is 1629405964. The provider is registered as an organization entity type.

The provider's business location address is:

6825 JIMMY CARTER BLVD
SUITE 1590
NORCROSS, GA
ZIP 30071-228
Phone: (678) 615-2565

The provider's authorized official is Luis Rafael Vizcarra-falla .
The authorized official title is Medical Director and has the following contact phone number (678) 615-2565.

The CLIA number assigned to this NPI record is 11D2069050 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/1/2013 and was last updated on 10/1/2013.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	68630	GEORGIA	Yes

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: 5/5/2024

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