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NPI Code Detail

MEDICARE: FLORENCE WESTERN MEDICAL CLINIC INC

MEDICARE: FLORENCE WESTERN MEDICAL CLINIC INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1154347797
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORENCE WESTERN MEDICAL CLINIC INC
Provider Business Mailing Address
First Line : 7301 S WESTERN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90047-2254
Country : US
Telephone Number : 323-778-2131
Fax Number :
Provider Business Practice Location Address
First Line : 7301 S WESTERN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90047-2254
Country : US
Telephone Number : 323-778-2131
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : KEVIN THOMAS
Credential : M.D.
Telephone Number : 323-778-2131
Provider Enumeration Date : 07/15/2006
Last Update Date : 01/29/2013

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Directions to “FLORENCE WESTERN MEDICAL CLINIC INC ” Practice Location

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