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General NPI Number Information
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NPI Number | 1952197923
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Entity Type | Organization
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Legal Business Name | CLINICA MEDICA SAN LORENZO, INC.
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 8534 ROSECRANS AVE
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City | PARAMOUNT
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State | CA
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Zip | 90723-3644
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Country | US
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Telephone | 562-602-8877
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Fax | 562-602-8844
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Provider Business Mailing Address
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Address Line | 1840 N HACIENDA BLVD STE 10
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City | LA PUENTE
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State | CA
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Zip | 91744-1143
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Country | US
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Telephone | 626-931-6618
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Fax | 626-931-6610
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Authorized Official
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Title or Position | CEO
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Name | DR. LORENZO VAZQUEZ
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Credential | MD
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Telephone | 626-422-5958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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