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NPI Code Detail

MEDICARE: CLINICA MONSIGNOR OSCAR A ROMERO

MEDICARE: CLINICA MONSIGNOR OSCAR A ROMERO
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
1261QF0400XFederally Qualified Health Center (FQHC)960001398CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316033533
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLINICA MONSIGNOR OSCAR A ROMERO
Provider Business Mailing Address
First Line : 123 S ALVARADO STREET
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-2201
Country : US
Telephone Number : 213-989-7700
Fax Number : 213-989-7701
Provider Business Practice Location Address
First Line : 2032 MARENGO STREET
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-1319
Country : US
Telephone Number : 213-989-7700
Fax Number : 323-221-4528
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : SANDRA ROSATTO
Credential :
Telephone Number : 213-201-2737
Provider Enumeration Date : 10/05/2006
Last Update Date : 08/12/2016

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