Maywood Healthcare Clinic, Inc.
Organization Active NPI Primary Care Clinic/Center · Maywood, CA
NPI 1013343078 · NPPES record last updated Sep 3, 2014
Key facts
- NPI
- 1013343078
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- License
- A70433 (CA)
- Legal business name
- MAYWOOD HEALTHCARE CLINIC, INC.
- Practice address
- 4205 Slauson Ave
Maywood, CA 90270-2835 - Phone
- (323) 560-0118
- Fax
- (323) 560-1302
- NPI assigned
- Sep 23, 2013
- Organization subpart
- No
Authorized official
- Name
- Mr. Rey Quinonez, PA-C
- Title
- Administrator
- Phone
- (323) 861-1510
Practitioners 1
-
Reynaldo Quinonez, PA19411
National Provider Directory
Locations
4205 Slauson Ave
Maywood, CA 90270
Phone (323) 560-0118
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | A70433 | CA | |
| Primary Care Clinic/Center | 261QP2300X | A70433 | CA | Yes |
Addresses
Primary practice location
4205 Slauson Ave
Maywood, CA 90270-2835
Mailing address
4205 Slauson Ave
Maywood, CA 90270-2835
Phone (323) 560-0118
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA1756 | Other | CA | PA-C CA LIC # |
| PA19411 | Other | CA | PA-C CA LIC # |
| A70433 | Other | CA | MD CA LIC # |
Other providers in Maywood, CA
- Mia Martinez
- Ashik Mathur
- Maywood Adult Day Health Care Center, LLC
- Maywood Family Dentistry
- Maywood Family Medical Center
- Maywood Skilled Nursing & Wellness Centre, LLC
- Alejandra Meza
- Mission City Community Network Inc
- Mojdeh Fatemi D.D.S., a Corporation
- Luis D Moreno
All providers in Maywood, CA · Primary Care Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.