| Doctor Name: | DR. CELERINA DE BORJA MEDINA |
| NPI Number: | 1356399919 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | A45547 |
| Business Practice Address: | 4149 Tweedy Boulevard Ste B South Gate, CA - 902806167 |
| Business Phone Number: | 3235644545 |
| Business Fax Number: | 3235643063 |
| Mailing Address: | 4149 Tweedy Boulevard, Ste B SOUTH GATE |
| State: | CA |
| Postal Code: | 902806167 |
| Phone Number: | 3235644545 |
| Fax Number: | 3235643063 |
| NPI Enumeration Date: | 05/05/2006 |
| NPI Last Update Date: | 06/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A45547 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |