Baseline Medical Clinic | |
330 N D St Ste 300 San Bernardino CA 92401-1522 | |
(909) 888-6602 | |
(909) 885-7494 |
Full Name | Baseline Medical Clinic |
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Speciality | Clinic/Center |
Location | 330 N D St Ste 300, San Bernardino, California |
Authorized Official Name and Position | Hoang-chuong N Vu (MEDICAL DIRECTOR) |
Authorized Official Contact | 9098886602 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Baseline Medical Clinic 330 N D St Ste 300 San Bernardino CA 92401-1522 Ph: (909) 888-6602 | Baseline Medical Clinic 330 N D St Ste 300 San Bernardino CA 92401-1522 Ph: (909) 888-6602 |
NPI Number | 1891862553 |
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Provider Enumeration Date | 11/29/2006 |
Last Update Date | 11/28/2017 |
Medicare PECOS PAC ID | 6103906524 |
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Medicare Enrollment ID | O20080110000218 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891862553 | NPI | - | NPPES |
GR0017240 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | C27156 (California) | Primary |
Provider Name | Hoang-chuong Vu |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1922135086 PECOS PAC ID: 7113026683 Enrollment ID: I20070625000225 |
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