| Aspen Medical Clinic Inc. | |
|
12368 Winesap Rd Apple Valley CA 92308-5143 | |
| (760) 240-5044 | |
| (760) 240-5119 |
| Full Name | Aspen Medical Clinic Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 12368 Winesap Rd, Apple Valley, California |
| Authorized Official Name and Position | Wahid Midou (OWNER) |
| Authorized Official Contact | 7602405044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspen Medical Clinic Inc. 12368 Winesap Rd Apple Valley CA 92308-5143 Ph: (760) 240-5044 | Aspen Medical Clinic Inc. 12368 Winesap Rd Apple Valley CA 92308-5143 Ph: (760) 240-5044 |
| NPI Number | 1467475806 |
|---|---|
| Provider Enumeration Date | 07/26/2006 |
| Last Update Date | 05/28/2008 |
| Medicare PECOS PAC ID | 9537163639 |
|---|---|
| Medicare Enrollment ID | O20060901000239 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467475806 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | A79778 (California) | Primary |
| Provider Name | Wahid Midou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275563967 PECOS PAC ID: 8527075076 Enrollment ID: I20060308000821 |
| Provider Name | Mazen K Munir |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205943446 PECOS PAC ID: 3870663578 Enrollment ID: I20080606000726 |
| Provider Name | Paramjit Sandhu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871756544 PECOS PAC ID: 2567644743 Enrollment ID: I20110309000310 |
| Provider Name | Tarek T Moqattash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801029483 PECOS PAC ID: 6002093200 Enrollment ID: I20110615000189 |
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