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General NPI Number Information
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NPI Number | 1609149772
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Entity Type | Organization
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Legal Business Name | CLINICA CATORCE
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Dates
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Enumeration Date | 02/20/2012
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Last Update Date | 02/20/2012
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Provider Practice Location Address
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Address Line | 1031 W KENSINGTON RD
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City | LOS ANGELES
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State | CA
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Zip | 90026-4353
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Country | US
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Telephone | 646-925-1084
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Fax |
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Provider Business Mailing Address
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Address Line | 1031 W KENSINGTON RD
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City | LOS ANGELES
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State | CA
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Zip | 90026-4353
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MARK MCDOWELL
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Credential | MD
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Telephone | 646-925-1084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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