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General NPI Number Information
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NPI Number | 1720239858
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Entity Type | Organization
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Legal Business Name | JOSE CLEMENTE NAVARRETE M D INC
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Dates
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Enumeration Date | 10/07/2008
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Last Update Date | 07/16/2013
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Provider Practice Location Address
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Address Line | 6043 ATLANTIC BLVD
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City | MAYWOOD
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State | CA
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Zip | 90270-3118
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Country | US
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Telephone | 323-771-9680
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Fax | 323-771-2989
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Provider Business Mailing Address
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Address Line | 6043 ATLANTIC BLVD
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City | MAYWOOD
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State | CA
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Zip | 90270-3118
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Country | US
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Telephone | 323-771-9680
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Fax | 323-771-2989
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Authorized Official
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Title or Position | OWNER
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Name | JOSE CLEMENTE NAVARRETE
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Credential | MD
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Telephone | 323-771-9680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A36377
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License Number State | CA
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