MEDICARE: CLINICA MEDICA SAN PEDRO OF CALIFORNIA, 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
1	208000000X	Pediatrics Physician
2	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1386927374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICA MEDICA SAN PEDRO OF CALIFORNIA, INC

Provider Business Mailing Address
First Line	:	11725 GARVEY AVE
Second Line	:	STE 5B
City	:	EL MONTE
State	:	CA
Zip	:	91732-4534
Country	:	US
Telephone Number	:	626-579-0999
Fax Number	:	626-579-2999

Provider Business Practice Location Address
First Line	:	11725 GARVEY AVE
Second Line	:	STE 5B
City	:	EL MONTE
State	:	CA
Zip	:	91732-4534
Country	:	US
Telephone Number	:	626-579-0999
Fax Number	:	626-579-2999

Authorized Official
Title or Position	:	PRESIDENT AND OWNER
Name	:	MR. JOSE MANUEL DIAZ
Credential	:	MD
Telephone Number	:	626-579-0999

Provider Enumeration Date	:	09/26/2011
Last Update Date	:	09/26/2011

Similar Medicare Providers

1316148885 — RENALDO L ESPINOSA DE LOS MONTEROS PA
Practice Location Address:

11725 GARVEY AVE , SUITE 5B
EL MONTE, CA
91732-4534

Practice Phone: 626-579-0707
Practice Fax: 626-579-0235

1144491259 — EVERARDO MEJIA
Practice Location Address:

11725 GARVEY AVE , STE 5B
EL MONTE, CA
91732-4534

Practice Phone: 626-579-0707
Practice Fax: 626-579-0235

1255280756 — KAYLA LYNNE SMITH
Practice Location Address:

6316 FIESTA DR
EL PASO, TX
79912-4534

Practice Phone: 915-887-1313
Practice Fax:

1114635406 — GREGORY AUSTIN JOY MD
Practice Location Address:

6221 MONITOR RD
EL DORADO, CA
95623-4534

Practice Phone: 530-622-9522
Practice Fax: 530-626-6888

1316819998 — JOSUE PAICO
Practice Location Address:

6300 FIESTA DR
EL PASO, TX
79912-4534

Practice Phone: 915-234-3241
Practice Fax:

1912589078 — JUAN GILBERTO LOZANO
Practice Location Address:

11629 LOWER AZUSA RD STE H
EL MONTE, CA
91732-1389

Practice Phone: 626-672-0224
Practice Fax:

Directions to “CLINICA MEDICA SAN PEDRO OF CALIFORNIA, INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.