Medina, Celerina De Borja

Medina, Celerina De Borja is an individual health care provider with primary practice located at 4149 Tweedy Boulevard Ste B, South Gate CA 90280-6167. She recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as her primary health care specialty. Medina, Celerina De Borja can be contacted via phone (323) 564-4545.

Contact Information

Primary practice address
4149 Tweedy Boulevard Ste B South Gate CA 90280-6167
Phone: (323) 564-4545
Fax: (323) 564-3063
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X A45547 California

Profile Details

NPI number 1356399919
LBN Legal business name Medina, Celerina De Borja
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Jun 29th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356399919 NPPES
California MEDICAID 00A455470

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