Dr Gregory Spencer Mynko, MD | |
32475 Oak Knoll Ln, Lake Elsinore, CA 92530-8324 | |
(951) 609-5028 | |
(951) 678-4287 |
Full Name | Dr Gregory Spencer Mynko |
---|---|
Gender | Male |
Speciality | General Practice |
Location | 32475 Oak Knoll Ln, Lake Elsinore, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225046568 | NPI | - | NPPES |
G 74144 | Other | CA | CA STATE MEDICAL LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207LP2900X | Anesthesiology - Pain Medicine | G 74144 (California) | Secondary |
208D00000X | General Practice | G74144 (California) | Primary |
Entity Name | American Current Care Of California A Medical Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750573622 PECOS PAC ID: 5799854303 Enrollment ID: O20080522000420 |
Entity Name | Hd Physical Medicine A Professional Medical Corporation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1982633863 PECOS PAC ID: 3678974243 Enrollment ID: O20210820003081 |
Mailing Address | Practice Location Address |
---|---|
Dr Gregory Spencer Mynko, MD 32475 Oak Knoll Ln, Lake Elsinore, CA 92530-8324 Ph: (951) 609-5028 | Dr Gregory Spencer Mynko, MD 32475 Oak Knoll Ln, Lake Elsinore, CA 92530-8324 Ph: (951) 609-5028 |
Thomas Edward Oliveira, D.O. General Practice Medicare: Accepting Medicare Assignments Practice Location: 506 W Graham Ave, Suite 107, Lake Elsinore, CA 92530 Phone: 951-471-5116 | |
Shafi Ullah Siddiqi, M.D. General Practice Medicare: Accepting Medicare Assignments Practice Location: 31569 Canyon Estates Dr, Ste 201, Lake Elsinore, CA 92532 Phone: 951-226-0866 Fax: 951-226-0868 |