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General NPI Number Information
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NPI Number | 1881237824
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Entity Type | Organization
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Legal Business Name | SOUTHERN CALIFORNIA FAMILY MEDICINE CLINIC, INC
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 10/22/2019
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Provider Practice Location Address
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Address Line | 709 N HILL ST STE 19
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City | LOS ANGELES
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State | CA
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Zip | 90012-2352
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Country | US
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Telephone | 213-537-0816
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Fax | 213-537-0812
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Provider Business Mailing Address
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Address Line | 709 N HILL ST STE 19
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City | LOS ANGELES
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State | CA
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Zip | 90012-2352
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Country | US
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Telephone | 213-537-0816
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Fax | 213-537-0812
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID H NGUYEN
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Credential | DO
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Telephone | 626-641-2119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics 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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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