| American Family Medical Group, Inc. | |
|
2414 S Fairview St Ste 112 Santa Ana CA 92704-5345 | |
| (714) 641-0121 | |
| (714) 641-2054 |
| Full Name | American Family Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 2414 S Fairview St Ste 112, Santa Ana, California |
| Authorized Official Name and Position | Lina R Monroe (OFFICE MANAGER) |
| Authorized Official Contact | 7146410121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| American Family Medical Group, Inc. 2414 S Fairview St Ste 112 Santa Ana CA 92704-5345 Ph: (714) 641-0121 | American Family Medical Group, Inc. 2414 S Fairview St Ste 112 Santa Ana CA 92704-5345 Ph: (714) 641-0121 |
| NPI Number | 1750410007 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 11/03/2011 |
| Medicare PECOS PAC ID | 2466435698 |
|---|---|
| Medicare Enrollment ID | O20040609001150 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750410007 | NPI | - | NPPES |
| 1740244532 | Other | CA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A39997 (California) | Primary |
| Provider Name | Mark N Monroe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740244532 PECOS PAC ID: 0446419931 Enrollment ID: I20120301000506 |
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