| Bendito Medical Corporation | |
|
1780 E Highland Ave San Bernardino CA 92404-4618 | |
| (909) 402-4601 | |
| (909) 402-4609 |
| Full Name | Bendito Medical Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 1780 E Highland Ave, San Bernardino, California |
| Authorized Official Name and Position | Chioma Kalu (MD/CEO) |
| Authorized Official Contact | 9094024601 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bendito Medical Corporation 1780 E Highland Ave San Bernardino CA 92404-4618 Ph: (818) 618-3728 | Bendito Medical Corporation 1780 E Highland Ave San Bernardino CA 92404-4618 Ph: (909) 402-4601 |
| NPI Number | 1679100911 |
|---|---|
| Provider Enumeration Date | 03/26/2020 |
| Last Update Date | 03/28/2022 |
| Medicare PECOS PAC ID | 3870988637 |
|---|---|
| Medicare Enrollment ID | O20220315001480 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679100911 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Chioma A Kalu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336387018 PECOS PAC ID: 8123267432 Enrollment ID: I20161013000819 |
| Provider Name | Tressa K Norton-rosales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023465747 PECOS PAC ID: 3779845755 Enrollment ID: I20180403001794 |
| Provider Name | Samantha Benin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396241915 PECOS PAC ID: 8527446756 Enrollment ID: I20220531002599 |
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