San Miguel Community Clinic

LBN: San Miguel Community Clinic
San Miguel Community Clinic is an health care organization with primary practice located at 825 N Park Ave , Pomona CA 91768-3002. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as the primary health care specialty. San Miguel Community Clinic can be contacted via phone (909) 622-9988, or through Laessig, Kj via phone (213) 742-0255.

Contact Information

Primary practice address
825 N Park Ave Pomona CA 91768-3002
Phone: (909) 622-9988
Fax: (909) 622-3452
Website:
Map and Directions
Authorized official contact:
Name: Laessig, Kj
Phone: (213) 742-0255

Health care specialties

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

Profile Details

NPI number 1942548342
LBN Legal business name San Miguel Community Clinic
DBA Doing business as
Authorized official Laessig, Kj
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 21st, 2013
Last updated Jan 21st, 2013 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942548342 NPPES
California MEDICAID GR0016851

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