AZUL MEDICAL CLINIC INC NPI 1679626436

NPI Information

NPI: 1679626436
Provider Name: AZUL MEDICAL CLINIC INC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 05D1013566

Address:
6517 EASTERN AVE
BELL GARDENS, CA
ZIP 90201
Phone: (323) 773-8295
Get Directions

AZUL MEDICAL CLINIC INC is a primary care clinic center in Bell Gardens, CA. AZUL MEDICAL CLINIC INC NPI is 1679626436. The provider is registered as an organization entity type.

The provider's business location address is:

6517 EASTERN AVE
BELL GARDENS, CA
ZIP 90201-003
Phone: (323) 773-8295
Fax: (323) 773-0656

The provider's authorized official is Francisco A Jimenez .
The authorized official title is President and has the following contact phone number (323) 773-8295.

The CLIA number assigned to this NPI record is 05D1013566 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/18/2007 and was last updated on 10/7/2014.

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
1	261QP2300X	Clinic/Center	Primary Care	17679	CALIFORNIA	No
2	261QP2300X	Clinic/Center	Primary Care	A40305	CALIFORNIA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	W16528	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	MEDICARE PROVIDER
2	GR0095220	MEDICAID	CALIFORNIA

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: 4/28/2024

NPI Synchronization or Removal

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