CLINICA MEDICA SAN MARCOS, INC (NPI# 1649457037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649457037 |
| Entity Type | Organization |
| Organization Name | CLINICA MEDICA SAN MARCOS, INC |
| Practice Address |
3221 Liberty Blvd South Gate CA 90280-2315 |
| Practice Telephone | 3235669171 |
| Practice Fax Number | 3235669178 |
| Mailing Telephone | 3235669171 |
| Mailing Fax Number | 3235669178 |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2013-01-10 |
| Authorized Official Name | GUSTAVO T. ROLDAN (MANAGER) |
| Authorized Official Telephone | 3235669171 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
0711339 | CA | Ambulatory Health Care Facilities |
| Street Address |
3221 LIBERTY BLVD |
| City | SOUTH GATE |
| State | CA |
| Zip Code | 90280-2315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790720381 | Gustavo Mario Roldan | Physician Assistant | 3221 Liberty Blvd, South Gate, CA 90280-2315 | 2006-06-18 |
| 1679773840 | Clinica Medica San Marcos Inc | General Practice | 3221 Liberty Blvd, South Gate, CA 90280-2315 | 2007-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861989758 | Downey Family Cosmetic Dentistry | Clinic/Center | 9212 Lakewood Blvd, Downey, CA 90280 | 2018-04-17 |
| 1720529936 | Carewest Non-emergency Services, LLC | Non-emergency Medical Transport (VAN) | 10423 Atlantic Ave, South Gate, CA 90280 | 2017-03-20 |
| 1669844593 | Consumerhealth, Inc. | Dentist | 9918 Atlantic Aveneue, South Gate, CA 90280 | 2015-10-30 |
| 1366810988 | T & T Care Inc | Pharmacy | 8330 Long Beach Blvd Ste 112, South Gate, CA 90280 | 2015-09-14 |
| 1831579234 | Mariana Silva | Licensed Psychiatric Technician | 8160 Victoria Ave. Apt. A, South Gate, CA 90280 | 2015-06-02 |
| 1417396060 | Compatior, Inc. | Community/Behavioral Health | 4363 Tweedy Blvd, South Gate, CA 90280 | 2013-06-17 |
| 1508158197 | Eddy Ang | Family Medicine | 8627 Atlantic Ave, South Gate, CA 90280 | 2011-05-13 |
| 1750528691 | Herbert Perez | Dental Assistant | 4149 Tweey Blvd #j, South Gate, CA 90280 | 2009-01-14 |
| 1962615773 | Harold Edward Potts | Chiropractor | 10010 California Ave., South Gate, CA 90280 | 2007-05-08 |
| 1821113507 | Magdy F Tadros | Dentist | 3173 Tweedy Blvd, South Gate, CA 90280 | 2007-03-20 |
| Find all providers in zip 90280 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982087763 | Robert Azurin, M.d. Inc | Clinic/Center | 4075 Tweedy Blvd, South Gate, CA 90280-6146 | 2015-06-30 |
| 1760894190 | Linda Barkodar, Md, Inc., Apc | Clinic/Center | 2809 Tweedy Blvd, South Gate, CA 90280-5538 | 2014-05-20 |
| 1700149663 | Robert Anthony Azurin | Clinic/Center | 4075 Tweedy Blvd, South Gate, CA 90280-6146 | 2012-06-16 |
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| Find all providers with the same taxonomy | ||||
| City | SOUTH GATE |
| Zip Code | 90280 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.