Provider Demographics
NPI:1033252333
Name:UNION MEDICAL CLINIC INC
Entity Type:Organization
Organization Name:UNION MEDICAL CLINIC INC
Other - Org Name:LORENZO A ALAAN MD INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LORENZO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALAAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-587-9141
Mailing Address - Street 1:PO BOX 2189
Mailing Address - Street 2:5421 PACIFIC BLVD
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255
Mailing Address - Country:US
Mailing Address - Phone:323-587-9141
Mailing Address - Fax:323-587-6074
Practice Address - Street 1:5421 PACIFIC BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255
Practice Address - Country:US
Practice Address - Phone:323-587-9141
Practice Address - Fax:323-587-6074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35589207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8152916OtherPIN
CA00A35589Medicaid
A84792Medicare UPIN
CA00A35589Medicaid