Clinica Santa Clara a Medical Corporation
Organization Active NPI Non-Pharmacy Dispensing Site · Cudahy, CA
NPI 1295168250 · NPPES record last updated Aug 14, 2013
Key facts
- NPI
- 1295168250
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Non-Pharmacy Dispensing Site 332900000X
- License
- A31709 (CA)
- Legal business name
- CLINICA SANTA CLARA A MEDICAL CORPORATION
- Practice address
- 7643 Atlantic Ave
Cudahy, CA 90201-5019 - Phone
- (323) 771-1713
- NPI assigned
- Aug 14, 2013
- Organization subpart
- Yes
- Parent organization (as reported)
- MEDVANTX, INC
Authorized official
- Name
- Kenny Heine
- Title
- VP of Operations
- Phone
- (858) 964-1506
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Clinica Santa Clara
- Part of
- Tri - State Medical Group Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-Pharmacy Dispensing Site | 332900000X | A31709 | CA | Yes |
Addresses
Primary practice location
7643 Atlantic Ave
Cudahy, CA 90201-5019
Mailing address
5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705
Other names
- Clinica Santa Clara
Other providers in Cudahy, CA
- Cherag Dinshaw Sarkari DDS a Dental Corporation
- Rodrigo Kennosuke Cifuentes
- City RX Pharmacy, Inc.
- Clinica Santa Clara
- Clinica Santa Clara
- Rachel Elizabeth Colon
- Community Family Guidance Center
- Creative Pathways ABA, LLC
- Jessica Joanna Cruz
- Cudahy Peritoneal Dialysis Center
All providers in Cudahy, CA · Non-Pharmacy Dispensing Site in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2013. 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.