| Organization Name: | UNIFIED CARE MEDICAL GROUP INC |
| NPI Number: | 1346607603 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RODERICK PEREZ RAMOS (CLINIC ADMINISTRATOR) |
| Mailing Address: | 2040 Pacific Coast Hwy Suite S Lomita |
| State: | CA US |
| Postal Code: | 907172660 |
| Phone Number: | 4243478008 |
| Fax Number: | |
| NPI Enumeration Date: | 01/18/2016 |
| NPI Last Update Date: | 05/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | PA19706 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |