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General NPI Number Information
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NPI Number | 1972146843
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Entity Type | Organization
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Legal Business Name | AFFORDABLE MEDICAL CENTER & URGENT CARE INC
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Dates
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Enumeration Date | 10/23/2019
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Last Update Date | 11/09/2020
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Provider Practice Location Address
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Address Line | 819 S VERMONT AVE
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City | LOS ANGELES
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State | CA
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Zip | 90005-1522
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Country | US
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Telephone | 323-300-5266
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Fax | 213-568-3077
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Provider Business Mailing Address
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Address Line | 819 S VERMONT AVE
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City | LOS ANGELES
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State | CA
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Zip | 90005-1522
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Country | US
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Telephone | 323-968-0302
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Fax | 213-568-3077
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ALFRED LUIS CISNEROS
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Credential | MD
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Telephone | 323-968-0302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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