OrganizationClinica Del Socorro Medical Group,Inc.Family MedicineAllopathic & Osteopathic PhysiciansPractice Address1061 E Vernon Ave, Suite 'F', Los Angeles, CA 90011-3772(323) 233-9686PECOS EnrollmentBased on the most recent information from CMS, provider Clinica Del Socorro Medical Group,Inc. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 15 days ago.Profile DetailsProvider ID1215263827Provider TypeOrganizationFull NameClinica Del Socorro Medical Group,Inc.SubpartNoEnumeration Date11/2/2009Last Updated11/18/2009Contact InformationPractice LocationPractice Address1061 E Vernon Ave, Suite 'F', Los Angeles, CA 90011-3772Phone(323) 233-9686Fax(323) 233-0595Mailing LocationMailing Address1061 E Vernon Ave, Suite 'F', Los Angeles, CA 90011-3772Phone(323) 233-9686Fax(323) 233-0595Authorized OfficialNameLawrence, Patrick B. (Director)Phone(323) 233-9686Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseC39153CaliforniaCode208D00000XDescriptionGeneral PracticeAllopathic & Osteopathic PhysiciansLicenseA20149California