Organization Name: | OMAR E ESPINOSA MD INC |
NPI Number: | 1013218627 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | OMAR EDUARDO ESPINOSA (PRESIDENT/CEO) |
Mailing Address: | 3030 W Temple St 106 Los Angeles |
State: | CA US |
Postal Code: | 900264533 |
Phone Number: | 2133879251 |
Fax Number: | 2133879241 |
NPI Enumeration Date: | 11/12/2010 |
NPI Last Update Date: | 11/12/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A23122 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |