| Organization Name: | CLINICA DEL SOCORRO MEDICAL GROUP,INC. |
| NPI Number: | 1215263827 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PATRICK B. LAWRENCE (DIRECTOR) |
| Mailing Address: | 1061 E Vernon Ave Suite 'f' Los Angeles |
| State: | CA US |
| Postal Code: | 900113772 |
| Phone Number: | 3232339686 |
| Fax Number: | 3232330595 |
| NPI Enumeration Date: | 11/02/2009 |
| NPI Last Update Date: | 11/18/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A20149 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |