MEDICARE: LOS ANGELES MEDICAL CLINIC CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	70	PR
2	103TC0700X	Clinical Psychologist	1820	PR
3	207Q00000X	Family Medicine Physician	013924	PR
4	207Q00000X	Family Medicine Physician	11058	PR
5	207R00000X	Internal Medicine Physician	9251	PR
6	207RC0000X	Cardiovascular Disease Physician	4847	PR
7	207RP1001X	Pulmonary Disease Physician	8908	PR
8	207V00000X	Obstetrics & Gynecology Physician	10561	PR
9	208100000X	Physical Medicine & Rehabilitation Physician	15909	PR
10	208D00000X	General Practice Physician	16296	PR
11	225100000X	Physical Therapist	624	PR
12	208D00000X	General Practice Physician	16341	PR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	3842	OTHER	PR	AMERICAN HEALTH MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4172	OTHER	PR	PMC
2	9090182	OTHER	PR	HUMANA
3	3153261	OTHER	PR	UIA
4	04486	OTHER	PR	AMERICAN HEALTH INC
5	9080048	OTHER	PR	HUMANA
7	4965	OTHER	PR	PALI

General Provider Information

NPI Number	:	1912970351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOS ANGELES MEDICAL CLINIC CORP

Provider Business Mailing Address
First Line	:	1400 CALLE SAN RAFAEL
Second Line	:	ESQ HIPODROMO SUITE 201
City	:	SAN JUAN
State	:	PR
Zip	:	00909-2693
Country	:	US
Telephone Number	:	787-721-6626
Fax Number	:	787-725-1287

Provider Business Practice Location Address
First Line	:	1400 CALLE SAN RAFAEL
Second Line	:	ESQ HIPODROMO SUITE 201
City	:	SANTURCE
State	:	PR
Zip	:	00909-2644
Country	:	US
Telephone Number	:	787-721-6626
Fax Number	:	787-725-1287

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MYRIAM SAEZ
Credential	:	MD
Telephone Number	:	787-721-0429

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	08/17/2018

Similar Medicare Providers

1023013653 — PODIATRY CENTER, PSC
Practice Location Address:

1413 AVE FERNANDEZ JUNCOS , STOP 20
SANTURCE, PR
00909-2649

Practice Phone: 787-724-0871
Practice Fax: 787-724-0886

1306843511 — DR. ANTOLIANO TORRES RODRIGUEZ
Practice Location Address:

1452 CALLE AMERICO SALAS , ESQ. PAVIA
SANTURCE, PR
00909-2157

Practice Phone: 787-722-1460
Practice Fax: 787-726-5223

1386641538 — BIANCA S PUJOL ANGOMAS M.D.
Practice Location Address:

312 AVE DE DIEGO , TORRE MUSEO BLDG
SANTURCE, PR
00909-1756

Practice Phone: 787-480-3702
Practice Fax: 787-724-4057

1154329605 — DR. WANDA RAMOS MD
Practice Location Address:

359 AVE DE DIEGO 501
SANTURCE, PR
00909-1740

Practice Phone: 787-722-0445
Practice Fax: 787-723-4415

1447251285 — DR. ANGEL LUIS FRAGUADA M.D.
Practice Location Address:

611 CALLE PAVIA , SUITE 112
SANTURCE, PR
00909-2239

Practice Phone: 787-728-9849
Practice Fax: 787-268-5366

1033101068 — MR. JOSE A MARQUES BIBILONI SR. MD
Practice Location Address:

MANUEL PAVIA FERNANDEZ 655 4TH PISO
SANTURCE, PR
00909

Practice Phone: 787-728-2479
Practice Fax: 787-786-7447

Directions to “LOS ANGELES MEDICAL CLINIC CORP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.