Bear Valley Clinica Medica Familiar A Medical Corporation | |
15532 Bear Valley Rd Victorville CA 92395-9260 | |
(760) 245-5959 | |
Not Available |
Full Name | Bear Valley Clinica Medica Familiar A Medical Corporation |
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Speciality | General Practice |
Location | 15532 Bear Valley Rd, Victorville, California |
Authorized Official Name and Position | Octavio Ruiz Villalpando (MEDICAL PROVIDER/OWNER) |
Authorized Official Contact | 7602455959 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bear Valley Clinica Medica Familiar A Medical Corporation 15532 Bear Valley Rd Victorville CA 92395-9260 Ph: (760) 245-5959 | Bear Valley Clinica Medica Familiar A Medical Corporation 15532 Bear Valley Rd Victorville CA 92395-9260 Ph: (760) 245-5959 |
NPI Number | 1093355109 |
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Provider Enumeration Date | 01/07/2020 |
Last Update Date | 01/07/2020 |
Medicare PECOS PAC ID | 5294158077 |
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Medicare Enrollment ID | O20200713001636 |
Identifier | Type | State | Issuer |
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1093355109 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Francisco A Jimenez |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1972696573 PECOS PAC ID: 2062493059 Enrollment ID: I20040526000527 |
Provider Name | Octavio Ruiz Villalpando |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194832816 PECOS PAC ID: 3870691926 Enrollment ID: I20070613000358 |
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