| Organization Name: | LA CLINICA DE LA RAZA, INC. |
| NPI Number: | 1316188543 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JANE GARCIA (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 50 E Lewelling Blvd San Lorenzo |
| State: | CA US |
| Postal Code: | 945801732 |
| Phone Number: | 5103173167 |
| Fax Number: | 5105354189 |
| NPI Enumeration Date: | 03/18/2009 |
| NPI Last Update Date: | 11/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS1000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Student Health |
| Taxonomy Definition: | |