NPIMap

Organization Active NPI

Clinica Medica San Pedro of California, Inc

  • Obstetrics & Gynecology Physician
  • El Monte, CA
National Provider Identifier
1386927374
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
CLINICA MEDICA SAN PEDRO OF CALIFORNIA, INC
Practice address
11725 Garvey Ave
Ste 5B
El Monte, CA 91732-4534
Phone
(626) 579-0999
Fax
(626) 579-2999
NPI assigned
Sep 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

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

Authorized official

Name
Mr. Jose Manuel Diaz, MD
Title
President and Owner
Phone
(626) 579-0999

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

11725 Garvey Ave
Ste 5B
El Monte, CA 91732-4534

Mailing address

11725 Garvey Ave
Ste 5B
El Monte, CA 91732-4534
Phone (626) 579-0999

National Provider Directory

National Provider Directory
Tax ID family
Clinica Medica San Pedro of California Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316995200000",
    "number": "1386927374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11725 GARVEY AVE",
            "address_2": "STE 5B",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917324534",
            "telephone_number": "626-579-0999",
            "fax_number": "626-579-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11725 GARVEY AVE",
            "address_2": "STE 5B",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917324534",
            "telephone_number": "626-579-0999",
            "fax_number": "626-579-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA MEDICA SAN PEDRO OF CALIFORNIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-26",
        "last_updated": "2011-09-26",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "MANUEL",
        "authorized_official_title_or_position": "PRESIDENT AND OWNER",
        "authorized_official_telephone_number": "626-579-0999",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Monte, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.