Pico Clinica Medica Latina, a Medical Group, Inc
Organization Active NPI General Practice Physician · Los Angeles, CA
NPI 1740329101 · NPPES record last updated Dec 9, 2009
Key facts
- NPI
- 1740329101
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- License
- A40110 (CA)
- Legal business name
- PICO CLINICA MEDICA LATINA, A MEDICAL GROUP, INC
- Practice address
- 1600 W Pico Blvd
Los Angeles, CA 90015-2410 - Phone
- (213) 386-5252
- Fax
- (213) 386-5323
- NPI assigned
- Feb 5, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Teresita Alonzo Zareno, MD
- Title
- Vice President
- Phone
- (213) 386-5252
National Provider Directory
Locations
1600 W Pico Blvd
Los Angeles, CA 90015
Phone (213) 386-5252
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | A40110 | CA | Yes |
| General Practice Physician |
208D00000X | A39524 | CA |
Addresses
Primary practice location
1600 W Pico Blvd
Los Angeles, CA 90015-2410
Mailing address
1600 W Pico Blvd
Los Angeles, CA 90015-2410
Phone (213) 386-5252
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0082120 | Medicaid | CA |
Other providers in Los Angeles, CA
- Andrew Calvin Pickles
- Judith Carol Pickles
- Joseph D Pickman
- Brent Bowen Pickrell
- Pico Athletic Club Inc
- Pico Health Care Inc
- Pico Healthcare Inc
- Pico Medical Rents & Sells Inc
- Pico Square Pharmacy RX Inc
- Pico Union Women'S Health Clinic
All providers in Los Angeles, CA · General Practice Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2009. 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.