Healthcare Provider Details

I. General information

NPI: 1508046251
Provider Name (Legal Business Name): CLINICA PRENATAL SAN JOSE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 HEMLOCK WAY STE 200
SANTA ANA CA
92707-3655
US

IV. Provider business mailing address

1220 HEMLOCK WAY STE. 201
SANTA ANA CA
92707-3650
US

V. Phone/Fax

Practice location:
  • Phone: 714-966-9795
  • Fax: 714-966-7869
Mailing address:
  • Phone: 714-966-9795
  • Fax: 714-966-7869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberA913090
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberG678871
License Number StateCA

VIII. Authorized Official

Name: ALLAN AKERMAN
Title or Position: OFFICE MANAGER
Credential: M.D
Phone: 714-966-9795