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General NPI Number Information
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NPI Number | 1225254055
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Entity Type | Organization
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Legal Business Name | CLINICA MEDICA FAMILIAR SAN JUDAS INC
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 3900 W 3RD ST
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City | LOS ANGELES
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State | CA
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Zip | 90020-2675
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Country | US
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Telephone | 213-427-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 3900 W 3RD ST
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City | LOS ANGELES
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State | CA
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Zip | 90020-2675
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Country | US
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Telephone | 213-427-0400
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSE A ORTIZ
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Credential | MD
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Telephone | 213-427-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A73634
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License Number State | CA
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