Provider Demographics
NPI:1962649418
Name:CLINIC MANAGEMENT CORPORATION OF AMERICA
Entity Type:Organization
Organization Name:CLINIC MANAGEMENT CORPORATION OF AMERICA
Other - Org Name:EL AMAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SULTAN
Authorized Official - Middle Name:SALEH
Authorized Official - Last Name:YASSIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:787-598-9459
Mailing Address - Street 1:PO BOX 29166
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0166
Mailing Address - Country:US
Mailing Address - Phone:787-641-3888
Mailing Address - Fax:
Practice Address - Street 1:282 AVE JESUS T PINERO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-3921
Practice Address - Country:US
Practice Address - Phone:787-763-2125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-20
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty