NPIMap

Organization Active NPI

Clinica Santa Fe

  • Multi-Specialty Clinic/Center
  • Duluth, GA
National Provider Identifier
1114141660
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
2007000070 Issued in GA
Legal business name
CLINICA SANTA FE
Practice address
3750 Venture Dr
Suite 130
Duluth, GA 30096-1808
Phone
(770) 495-7942
Fax
(770) 495-7943
NPI assigned
Apr 13, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Manuel Lozano
Title
Owner
Phone
(770) 495-7942

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 2007000070 GA Primary

Addresses

Primary practice location

3750 Venture Dr
Suite 130
Duluth, GA 30096-1808

Mailing address

3750 Venture Dr
Suite 130
Duluth, GA 30096-1808
Phone (770) 495-7942

National Provider Directory

National Provider Directory
Tax ID family
Clinica Santa Fe2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3750 Venture Dr
Ste 130
Duluth, GA 30096
Phone (770) 495-7942

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114141660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 VENTURE DR",
            "address_2": "SUITE 130",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961808",
            "telephone_number": "770-495-7942",
            "fax_number": "770-495-7943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 VENTURE DR",
            "address_2": "SUITE 130",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961808",
            "telephone_number": "770-495-7942",
            "fax_number": "770-495-7943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA SANTA FE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOZANO",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-495-7942",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "GA",
            "license": "2007000070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.