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General NPI Number Information
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NPI Number | 1104873686
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Entity Type | Organization
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Legal Business Name | SANTA ANA CLINICA MEDICA GENERAL MEDICAL CENTER INC.
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 01/27/2020
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Provider Practice Location Address
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Address Line | 505 N MAIN ST
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City | SANTA ANA
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State | CA
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Zip | 92701-4619
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Country | US
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Telephone | 714-567-0101
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Fax | 714-567-9279
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Provider Business Mailing Address
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Address Line | PO BOX 546
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City | BEVERLY HILLS
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State | CA
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Zip | 90213-0546
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Country | US
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Telephone | 310-779-4474
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Fax | 424-278-1390
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARITZA MARIBEL MALDONADO
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Credential |
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Telephone | 103-779-4474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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