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General NPI Number Information
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NPI Number | 1942312715
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Entity Type | Organization
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Legal Business Name | CLINICA MEDICA AMERICANA MEDICAL CENTER
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 03/08/2012
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Provider Practice Location Address
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Address Line | 4075 WHITTIER BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90023-2525
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Country | US
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Telephone | 323-264-4924
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Fax | 323-264-4967
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Provider Business Mailing Address
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Address Line | 4075 WHITTIER BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90023-2525
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Country | US
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Telephone | 323-264-4924
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Fax | 323-264-4967
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Authorized Official
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Title or Position | PHYSICIAN MANAGER
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Name | DR. LEONIDAS VOLTAIRE SISON MEJIA
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Credential | M.D.
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Telephone | 323-264-4924
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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 |
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License Number State | CA
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