Dr Kofi Adade-boafo, MD | |
2150 N Waterman Ave, Ste 200, San Bernardino, CA 92404-4811 | |
(909) 887-7951 | |
(909) 883-1634 |
Full Name | Dr Kofi Adade-boafo |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 2150 N Waterman Ave, San Bernardino, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003898792 | NPI | - | NPPES |
A77940 | Other | CA | MD LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | A77940 (California) | Primary |
Entity Name | Pinnacle Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1376876912 PECOS PAC ID: 4880667609 Enrollment ID: O20040818001020 |
Mailing Address | Practice Location Address |
---|---|
Dr Kofi Adade-boafo, MD Po Box 12209, San Bernardino, CA 92423-2209 Ph: (909) 335-4188 | Dr Kofi Adade-boafo, MD 2150 N Waterman Ave, Ste 200, San Bernardino, CA 92404-4811 Ph: (909) 887-7951 |
Dr. Sajad Jawad Khazal, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 250 E Caroline St Ste E, San Bernardino, CA 92408 Phone: 909-651-1910 | |
Dr. Irene Styadi Tsai, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 685 Carnegie Dr, Ste. #230, San Bernardino, CA 92408 Phone: 909-890-0407 | |
Swapna S. Kudtarkar, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 401 E Highland Ave Ste 450a, San Bernardino, CA 92404 Phone: 909-864-4700 Fax: 909-883-0459 | |
Angie Bagheri Cook, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 565 N. Mount Vernon Ave, San Bernardino, CA 92411 Phone: 909-884-9091 | |
Mrs. Amal Shoukry Ibrahim, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 565 N. Mt. Vernon Ave, San Bernardino, CA 92411 Phone: 909-884-9091 Fax: 909-383-7013 | |
Ms. Lanny Nizar, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2101 N Waterman Ave, San Bernardino, CA 92404 Phone: 909-881-4315 Fax: 909-881-4474 |