NPIMap

Organization Active NPI

Guadalajara Medical Clinic

  • Primary Care Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1245450212
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
GUADALAJARA MEDICAL CLINIC
Practice address
2705 Whittier Blvd
Los Angeles, CA 90023-1441
Phone
(323) 263-3861
Fax
(323) 262-7132
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Authorized official

Name
Victor Manuel Pedroza, M.D
Title
MD
Phone
(323) 263-3861

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

2705 Whittier Blvd
Los Angeles, CA 90023-1441

Mailing address

2705 Whittier Blvd
Los Angeles, CA 90023-1441
Phone (323) 263-3861

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327363200000",
    "number": "1245450212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900231441",
            "telephone_number": "323-263-3861",
            "fax_number": "323-262-7132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900231441",
            "telephone_number": "323-263-3861",
            "fax_number": "323-262-7132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUADALAJARA MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2012-01-24",
        "status": "A",
        "authorized_official_last_name": "PEDROZA",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "MANUEL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "323-263-3861",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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.