Clinica Medica Latina, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CLINICA MEDICA LATINA, INC

Practice address

24805 Alessandro Blvd Ste 8
Moreno Valley, CA 92553-6101

Phone

(951) 601-6618

Fax

(951) 247-6218

NPI assigned

Sep 19, 2018

Organization subpart

No

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

Authorized official

Name

Lorenzo Moises Vazquez, M.D.NPI 1760521322

Title

Ceo / Owner

Phone

(951) 601-6618

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lorenzo Vazquez, MD

  • Family Medicine Physician
  • La Puente, CA
  • NPI 1760521322
  Medicare reassignment NPD Authorized official
• John Denton Olson, P.A.- C

  • Physician Assistant
  • Temecula, CA
  • NPI 1326340225
  Medicare reassignment
• Ruquia Dost, PA-C

  • Physician Assistant
  • La Puente, CA
  • NPI 1205039310
  NPD
• Yanina Linda Moya, P.A

  • Physician Assistant
  • Moreno Valley, CA
  • NPI 1760707897
  NPD (past)

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537315200000",
    "number": "1922582592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24805 ALESSANDRO BLVD STE 8",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925536101",
            "telephone_number": "951-601-6618",
            "fax_number": "951-247-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24805 ALESSANDRO BLVD STE 8",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925536101",
            "telephone_number": "951-601-6618",
            "fax_number": "951-247-6218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA MEDICA LATINA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-09-19",
        "status": "A",
        "authorized_official_last_name": "VAZQUEZ",
        "authorized_official_first_name": "LORENZO",
        "authorized_official_middle_name": "MOISES",
        "authorized_official_title_or_position": "CEO / OWNER",
        "authorized_official_telephone_number": "951-601-6618",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "A70384",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": ".",
            "identifier": ".",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas Michael Clements, D.O.
• Josh Lee Cleope
• Janean Marie Cleveland
• Christy Clever, M.S.W.
• Bobby Clifton Jr.
• Cloud Holdings, LLC
• Clover&Co
• Michael F Clyburn, PT
• Coalition of Registered Nurses 4 Healthy Communities
• Coast 2 Coast Carriers 2

• Family Medicine Physician in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.