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General NPI Number Information
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NPI Number | 1912970351
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Entity Type | Organization
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Legal Business Name | LOS ANGELES MEDICAL CLINIC CORP
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 1400 CALLE SAN RAFAEL ESQ HIPODROMO SUITE 201
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City | SANTURCE
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State | PR
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Zip | 00909-2644
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Country | US
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Telephone | 787-721-6626
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Fax | 787-725-1287
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Provider Business Mailing Address
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Address Line | 1400 CALLE SAN RAFAEL ESQ HIPODROMO SUITE 201
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City | SAN JUAN
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State | PR
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Zip | 00909-2693
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Country | US
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Telephone | 787-721-6626
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Fax | 787-725-1287
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MYRIAM SAEZ
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Credential | MD
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Telephone | 787-721-0429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 70
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1820
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 013924
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License Number State | PR
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11058
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License Number State | PR
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 9251
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License Number State | PR
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Taxonomy #6
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 4847
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License Number State | PR
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Taxonomy #7
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 8908
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License Number State | PR
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Taxonomy #8
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 10561
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License Number State | PR
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Taxonomy #9
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 15909
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License Number State | PR
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Taxonomy #10
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 16296
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License Number State | PR
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Taxonomy #11
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 624
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License Number State | PR
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Taxonomy #12
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 16341
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License Number State | PR
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