Provider Demographics
NPI:1386244952
Name:EL MILAGRO FAMILY MEDICAL CARE INC.
Entity type:Organization
Organization Name:EL MILAGRO FAMILY MEDICAL CARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:G
Authorized Official - Last Name:KUON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-516-0060
Mailing Address - Street 1:2321 W WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-3006
Mailing Address - Country:US
Mailing Address - Phone:323-516-0060
Mailing Address - Fax:323-516-0028
Practice Address - Street 1:2321 W WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3006
Practice Address - Country:US
Practice Address - Phone:323-516-0060
Practice Address - Fax:323-516-0028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-31
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care