| Ageless Health Group, A Professional Corp Nursing | |
|
703 E E St Ontario CA 91764-3820 | |
| (909) 435-4707 | |
| Not Available |
| Full Name | Ageless Health Group, A Professional Corp Nursing |
|---|---|
| Speciality | Clinic/Center |
| Location | 703 E E St, Ontario, California |
| Authorized Official Name and Position | Sonia Yenitza Rodrigues (CEO) |
| Authorized Official Contact | 9094354707 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ageless Health Group, A Professional Corp Nursing 703 E E St Ontario CA 91764-3820 Ph: (909) 435-4707 | Ageless Health Group, A Professional Corp Nursing 703 E E St Ontario CA 91764-3820 Ph: (909) 435-4707 |
| NPI Number | 1033829478 |
|---|---|
| Provider Enumeration Date | 11/28/2022 |
| Last Update Date | 11/28/2022 |
| Medicare PECOS PAC ID | 1759720378 |
|---|---|
| Medicare Enrollment ID | O20240416001677 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033829478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 3140N1450X | Skilled Nursing Facility - Nursing Care, Pediatric | (* (Not Available)) | Secondary |
| Provider Name | Isabelle Wilcox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124895164 PECOS PAC ID: 1658710272 Enrollment ID: I20240514000772 |
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