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BALDWIN PARK MEDICAL CLINIC INC NPI 1750728663


NPI Information

NPI: 1750728663
Provider Name: BALDWIN PARK MEDICAL CLINIC INC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D2076924

Address:
14051 RAMONA PKWY
BALDWIN PARK, CA
ZIP 91706
Phone: (626) 960-3753
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BALDWIN PARK MEDICAL CLINIC INC is a family medicine in Baldwin Park, 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. BALDWIN PARK MEDICAL CLINIC INC NPI is 1750728663. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

14051 RAMONA PKWY
BALDWIN PARK, CA
ZIP 91706-114
Phone: (626) 960-3753
Fax: (626) 962-9866

The provider's authorized official is Terry M Lee .
The authorized official title is President and has the following contact phone number (626) 960-3753.

The CLIA number assigned to this NPI record is 05D2076924 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/31/2013 and was last updated on 4/23/2020.


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
1174400000XSpecialistG62452CALIFORNIANo
2207Q00000XFamily MedicineYes

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
1G62452MEDICAIDCALIFORNIA

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

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