Provider Demographics
NPI:1700214160
Name:FAMILY MEDICAL CLINICS OF CALIFORNIA, INC
Entity Type:Organization
Organization Name:FAMILY MEDICAL CLINICS OF CALIFORNIA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSSEF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-728-2020
Mailing Address - Street 1:2300 W BEVERLY BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-2379
Mailing Address - Country:US
Mailing Address - Phone:323-728-2020
Mailing Address - Fax:
Practice Address - Street 1:2300 W BEVERLY BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-2379
Practice Address - Country:US
Practice Address - Phone:323-728-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42255207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty