Healthcare Provider Details

I. General information

NPI: 1861361537
Provider Name (Legal Business Name): REPUBLIC MEDICAL CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2025
Last Update Date: 11/01/2025
Certification Date: 11/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6122 WHITTIER BLVD
LOS ANGELES CA
90022-4504
US

IV. Provider business mailing address

6122 WHITTIER BLVD
LOS ANGELES CA
90022-4504
US

V. Phone/Fax

Practice location:
  • Phone: 323-490-7272
  • Fax: 323-490-7272
Mailing address:
  • Phone: 323-490-7272
  • Fax: 323-490-7272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALFREDO GARCIA
Title or Position: PRESIDENT
Credential: NP
Phone: 323-490-7272