| Advanced Medical Center, Inc. | |
|
491 University Ave W Suite# B Saint Paul MN 55103-1936 | |
| (651) 771-5778 | |
| (651) 771-5775 |
| Full Name | Advanced Medical Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 491 University Ave W, Saint Paul, Minnesota |
| Authorized Official Name and Position | Peter Thai Yang (CEO) |
| Authorized Official Contact | 6517715778 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Medical Center, Inc. 491 University Ave W Suite# B Saint Paul MN 55103-1936 Ph: (651) 771-5778 | Advanced Medical Center, Inc. 491 University Ave W Suite# B Saint Paul MN 55103-1936 Ph: (651) 771-5778 |
| NPI Number | 1215187471 |
|---|---|
| Provider Enumeration Date | 09/24/2008 |
| Last Update Date | 03/04/2009 |
| Medicare PECOS PAC ID | 4486710118 |
|---|---|
| Medicare Enrollment ID | O20090305000025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215187471 | NPI | - | NPPES |
| 529105400 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 44150 (Minnesota) | Primary |
| Provider Name | Peter Yang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750459012 PECOS PAC ID: 2860439122 Enrollment ID: I20050408000672 |
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