| Acn Medical Group Inc | |
|
423 Broadway Suite 604 Millbrae CA 94030-1905 | |
| (650) 732-9721 | |
| (510) 323-4286 |
| Full Name | Acn Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 423 Broadway, Millbrae, California |
| Authorized Official Name and Position | Andrew Ng (OWNER) |
| Authorized Official Contact | 6507329721 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Acn Medical Group Inc 423 Broadway Suite 604 Millbrae CA 94030-1905 Ph: (650) 732-9721 | Acn Medical Group Inc 423 Broadway Suite 604 Millbrae CA 94030-1905 Ph: (650) 732-9721 |
| NPI Number | 1154747020 |
|---|---|
| Provider Enumeration Date | 03/14/2014 |
| Last Update Date | 07/25/2014 |
| Medicare PECOS PAC ID | 3577788785 |
|---|---|
| Medicare Enrollment ID | O20140702000239 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154747020 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A107327 (California) | Primary |
| Provider Name | Andrew Chi-wei Ng |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871716910 PECOS PAC ID: 2163589243 Enrollment ID: I20110811000397 |
| Provider Name | Melissa A Frederick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033238076 PECOS PAC ID: 0244489425 Enrollment ID: I20121003000395 |
| Provider Name | Lashunda Kelley Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477962595 PECOS PAC ID: 9436371275 Enrollment ID: I20160920002707 |
| Provider Name | Teklehaimanot Abraha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013441229 PECOS PAC ID: 8628340874 Enrollment ID: I20170822004090 |
| Provider Name | Jenny Salud Jimenez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881097210 PECOS PAC ID: 5395967111 Enrollment ID: I20180503000557 |
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