San Gabriel Clinical Laboratories

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLF335013 Issued in CA

Legal business name

SAN GABRIEL CLINICAL LABORATORIES

Practice address

201 S Mission Dr
Suite 120
San Gabriel, CA 91776-1164

Phone

(626) 281-8190

Fax

(626) 281-8129

NPI assigned

Feb 26, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Montano Deleon Geronimo Jr., CPT1

Title

Laboratory Manager

Phone

(626) 281-8190

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316073349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S MISSION DR",
            "address_2": "SUITE 120",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761164",
            "telephone_number": "626-281-8190",
            "fax_number": "626-281-8129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S MISSION DR",
            "address_2": "SUITE 120",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761164",
            "telephone_number": "626-281-8190",
            "fax_number": "626-281-8129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN GABRIEL CLINICAL LABORATORIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GERONIMO",
        "authorized_official_first_name": "MONTANO",
        "authorized_official_middle_name": "DELEON",
        "authorized_official_title_or_position": "LABORATORY MANAGER",
        "authorized_official_telephone_number": "626-281-8190",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "CPT1"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF335013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruben A Salgado Dominguez, PMHNP
• Jacqueline Salgado
• Monique Alysse Salgado
• Armando Salinas, LVN
• Cecilia Samartin, MFT
• San Gabriel Family Dentistry
• San Gabriel Healthcare & Wellness Centre, LP (Ivy Creek Healthcare & Wellness Centre)
• San Gabriel Medical Investors, LLC (Life Care Center of San Gabriel)
• San Gabriel Medical Investors, LLC (Life Care Center of San Gabriel)
• San Gabriel Nephrology Services LLC (Quality Dialysis Center)

• Clinical Medical Laboratory in San Gabriel, CA
• Providers in San Gabriel, CA by specialty
• Clinical Medical Laboratory in California

• 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.