| Andres A De La Llana Md Inc | |
|
15982 Quantico Rd Ste C Apple Valley CA 92307-1382 | |
| (760) 646-9010 | |
| (760) 810-0267 |
| Full Name | Andres A De La Llana Md Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 15982 Quantico Rd Ste C, Apple Valley, California |
| Authorized Official Name and Position | Andres Gavino Alvarez De La Llana (OWNER) |
| Authorized Official Contact | 7606469010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Andres A De La Llana Md Inc 15982 Quantico Rd Ste C Apple Valley CA 92307-1382 Ph: (760) 646-9010 | Andres A De La Llana Md Inc 15982 Quantico Rd Ste C Apple Valley CA 92307-1382 Ph: (760) 646-9010 |
| NPI Number | 1942735923 |
|---|---|
| Provider Enumeration Date | 04/27/2017 |
| Last Update Date | 04/27/2017 |
| Medicare PECOS PAC ID | 8527336130 |
|---|---|
| Medicare Enrollment ID | O20170622000353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942735923 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A54374 (California) | Primary |
| Provider Name | Andres Gavino A De La Llana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497802094 PECOS PAC ID: 1557304334 Enrollment ID: I20050602000672 |
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