Provider Demographics
NPI:1528553211
Name:LA ESPERANZA MEDICAL CLINIC, INC
Entity Type:Organization
Organization Name:LA ESPERANZA MEDICAL CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ELVIRA
Authorized Official - Middle Name:P
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:562-682-7683
Mailing Address - Street 1:5985 FLORENCE AVE STE O
Mailing Address - Street 2:
Mailing Address - City:BELL GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90201-6755
Mailing Address - Country:US
Mailing Address - Phone:562-381-2235
Mailing Address - Fax:562-381-2902
Practice Address - Street 1:5985 FLORENCE AVE STE O
Practice Address - Street 2:
Practice Address - City:BELL GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90201-6755
Practice Address - Country:US
Practice Address - Phone:562-381-2235
Practice Address - Fax:562-381-2902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA208000000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty