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NPI Code Detail

MEDICARE: FCS - MONTEBELLO

MEDICARE: FCS - MONTEBELLO
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
1332900000XNon-Pharmacy Dispensing SiteG52360CA

General Provider Information

NPI Number : 1972778025
Entity Type Code : Organization
Provider Name (Legal Business Name) : FCS - MONTEBELLO
Provider Business Mailing Address
First Line : 5626 OBERLIN DR STE 110
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-1705
Country : US
Telephone Number : 323-317-9200
Fax Number :
Provider Business Practice Location Address
First Line : 815 WASHINGTON BLVD
Second Line :
City : MONTEBELLO
State : CA
Zip : 90640-6123
Country : US
Telephone Number : 323-728-3955
Fax Number :
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : MAURICIO EDUARDO BUENO
Credential : MD
Telephone Number : 323-791-0557
Provider Enumeration Date : 04/29/2008
Last Update Date : 03/27/2026

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Directions to “FCS - MONTEBELLO ” Practice Location

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