| Organization Name: | SAN LUCAS MEDICAL CLINIC, INC |
| NPI Number: | 1295156982 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VITAL HINOJOSA (MEDICAL DIRECTOR & OWNER) |
| Mailing Address: | 13939 San Antonio Dr Norwalk |
| State: | CA US |
| Postal Code: | 906504036 |
| Phone Number: | 2139891535 |
| Fax Number: | 8888827876 |
| NPI Enumeration Date: | 12/23/2013 |
| NPI Last Update Date: | 12/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A37463 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |