Healthcare Provider Details

I. General information

NPI: 1790701514
Provider Name (Legal Business Name): LATINO HEALTH SERVICES MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 N MAIN ST STE 100
SANTA ANA CA
92701-4684
US

IV. Provider business mailing address

517 N MAIN ST STE 100
SANTA ANA CA
92701-4684
US

V. Phone/Fax

Practice location:
  • Phone: 714-647-0401
  • Fax: 714-647-9465
Mailing address:
  • Phone: 714-647-0401
  • Fax: 714-647-9465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FRANCISCO A JIMENEZ
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 714-647-0401