Provider Demographics
NPI:1750037537
Name:CARIDAD MEDICAL CLINIC INC
Entity Type:Organization
Organization Name:CARIDAD MEDICAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DELMURO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-539-2200
Mailing Address - Street 1:2090 S EUCLID ST STE 104
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-3141
Mailing Address - Country:US
Mailing Address - Phone:714-539-2200
Mailing Address - Fax:
Practice Address - Street 1:2090 S EUCLID ST STE 104
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92802-3141
Practice Address - Country:US
Practice Address - Phone:714-539-2200
Practice Address - Fax:714-539-2277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty