Brian Koffman, MD | |
1514 Valley Vista Dr, Diamond Bar, CA 91765-3929 | |
(909) 860-1144 | |
(909) 860-8307 |
Full Name | Brian Koffman |
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Gender | Male |
Speciality | Family Medicine |
Location | 1514 Valley Vista Dr, Diamond Bar, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326049164 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | G36410 (California) | Primary |
Entity Name | Providence Medical Foundation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285890624 PECOS PAC ID: 8921993205 Enrollment ID: O20040216001346 |
Mailing Address | Practice Location Address |
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Brian Koffman, MD 1514 Valley Vista Dr, Diamond Bar, CA 91765-3929 Ph: () - | Brian Koffman, MD 1514 Valley Vista Dr, Diamond Bar, CA 91765-3929 Ph: (909) 860-1144 |
Aaron Lin, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1514 Valley Vista Dr, St Jude Heritage Medical Group, Diamond Bar, CA 91765 Phone: 909-860-1144 | |
Melissa A Trevelline, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1111 Grand Ave Ste L, Diamond Bar, CA 91765 Phone: 909-551-0205 Fax: 909-345-7084 | |
Michelle Kang Yun Mo, FNP-BC Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2020 S Brea Canyon Rd Ste A1, Diamond Bar, CA 91765 Phone: 909-861-6853 | |
Sarom Pyun, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1514 Valley Vista Dr, Diamond Bar, CA 91765 Phone: 909-860-1144 | |
Yann Ping Pan, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2605 Indian Creek Rd, Diamond Bar, CA 91765 Phone: 917-292-3995 | |
Douglas Starr, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1514 Valley Vista Dr, Diamond Bar, CA 91765 Phone: 909-860-1144 Fax: 909-860-8307 | |
William Fenerty, Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1514 Valley Vista Dr, Diamond Bar, CA 91765 Phone: 714-449-4842 Fax: 714-449-4816 |