| Organization Name: | CLINICA LOS REMEDIOS PEDIATRIC FAMILY MEDICAL CLINIC, INC. |
| NPI Number: | 1114222130 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REYNALDO LIMPIN MAKABALI (PRESIDENT) |
| Mailing Address: | 2400 W 7th St Suite 110 Los Angeles |
| State: | CA US |
| Postal Code: | 900575008 |
| Phone Number: | 2133899595 |
| Fax Number: | 2133892556 |
| NPI Enumeration Date: | 01/22/2011 |
| NPI Last Update Date: | 05/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |