Port Medical San Pedro is a
General Practice based in San Pedro, California. Port Medical San Pedro is licensed to practice in * (Not Available) (license number ) and their current practice location is
407 N Harbor Blvd, San Pedro, California. It can be reached at their office (for appointments etc.) via phone at
(310) 832-4598.
NPI number for Port Medical San Pedro is 1952620049 and their current mailing address is 407 N Harbor Blvd, San Pedro, California. Port Medical San Pedro
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1952620049.
Healthcare Provider's Profile
| Full Name | Port Medical San Pedro |
|---|
| Type | Facility |
|---|
| Speciality | General Practice |
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| Location | 407 N Harbor Blvd, San Pedro, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1952620049
- Provider Enumeration Date: 05/27/2010
- Last Update Date: 12/18/2013
Medical Identifiers
Medical identifiers for Port Medical San Pedro such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1952620049 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | DC22546 (California) | Secondary |
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 111NS0005X | Chiropractor - Sports Physician | DC22546 (California) | Secondary |
| 171100000X | Acupuncturist | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Port Medical San Pedro is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Port Medical San Pedro
407 N Harbor Blvd,
San Pedro, CA 90731-2243
Ph: (310) 832-4598 | Port Medical San Pedro
407 N Harbor Blvd,
San Pedro, CA 90731-2243
Ph: (310) 832-4598 |
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