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NPI Code Detail

MEDICARE: SENIOR CARE CLINIC A MEDICAL CORPORATION

MEDICARE: SENIOR CARE CLINIC A MEDICAL CORPORATION
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
1207RG0300XGeriatric Medicine (Internal Medicine) PhysicianA72860CA
2207RG0300XGeriatric Medicine (Internal Medicine) PhysicianA77545CA
3207RG0300XGeriatric Medicine (Internal Medicine) PhysicianA51085CA

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 : 1942354857
Entity Type Code : Organization
Provider Name (Legal Business Name) : SENIOR CARE CLINIC A MEDICAL CORPORATION
Provider Business Mailing Address
First Line : 1700 CESAR CHAVEZ AVE
Second Line : # 3900
City : LOS ANGELES
State : CA
Zip : 90033-2414
Country : US
Telephone Number : 323-307-0800
Fax Number : 323-307-0803
Provider Business Practice Location Address
First Line : 1700 CESAR CHAVEZ AVE
Second Line : # 3900
City : LOS ANGELES
State : CA
Zip : 90033-2414
Country : US
Telephone Number : 323-307-0800
Fax Number : 323-307-0803
Authorized Official
Title or Position : PRESIDENT
Name : DR. AZMY FOUAD GHALY
Credential : MEDICAL DOCTOR
Telephone Number : 323-307-0800
Provider Enumeration Date : 01/22/2007
Last Update Date : 06/05/2023

Similar Medicare Providers

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Practice Location Address:
1720 E CESAR E CHAVEZ AVE
LOS ANGELES, CA
90033-2414
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Practice Fax:
1689610057 — RUBEN R BRECHNER M.D.
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1093757064 — JENNIFER RANCHEZ N.P.
Practice Location Address:
1720 E CESAR E CHAVEZ AVE , EMERGENCY DEPT.
LOS ANGELES, CA
90033-2414
Practice Phone: 323-268-5000
Practice Fax:
1831787027 — NATHANAEL MICHAEL MORALES
Practice Location Address:
1720 E CESAR E CHAVEZ AVE
LOS ANGELES, CA
90033-2414
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Practice Fax:
1821925058 — GILLIAN ERICA JACOBSEN MD, PHD
Practice Location Address:
1720 E CESAR E CHAVEZ AVE
LOS ANGELES, CA
90033-2414
Practice Phone: 323-260-5789
Practice Fax:
1942137716 — DR. KIRRA MARIE RIVERA DO
Practice Location Address:
1720 E CESAR E CHAVEZ AVE
LOS ANGELES, CA
90033-2414
Practice Phone: 323-268-5000
Practice Fax:
1578490199 — DAWNICA NADORA
Practice Location Address:
1720 E CESAR E CHAVEZ AVE
LOS ANGELES, CA
90033-2414
Practice Phone: 323-260-5789
Practice Fax:

Directions to “SENIOR CARE CLINIC A MEDICAL CORPORATION ” Practice Location

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