Healthcare Provider Details

I. General information

NPI: 1598548604
Provider Name (Legal Business Name): MEDICA DE LA CUIDAD MAZATLAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLVD DE LAR MARINA 2207
MAZATLAN SINALOA
82103
MX

IV. Provider business mailing address

3422 BUSINESS CENTER DR STE 4056531
PEARLAND TX
77584-4155
US

V. Phone/Fax

Practice location:
  • Phone: 888-449-7799
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: GARY MONK
Title or Position: MGR
Credential: MGR
Phone: 440-568-0208