| Blanco Family Medicine | |
|
380 W Badillo St Covina CA 91723-1827 | |
| (626) 915-3000 | |
| (626) 915-3004 |
| Full Name | Blanco Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 380 W Badillo St, Covina, California |
| Authorized Official Name and Position | Debra Blanco (SECRETARY) |
| Authorized Official Contact | 6269153000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blanco Family Medicine 380 W Badillo St Covina CA 91723-1827 Ph: (626) 915-3000 | Blanco Family Medicine 380 W Badillo St Covina CA 91723-1827 Ph: (626) 915-3000 |
| NPI Number | 1922424902 |
|---|---|
| Provider Enumeration Date | 03/13/2014 |
| Last Update Date | 03/13/2014 |
| Medicare PECOS PAC ID | 3678903424 |
|---|---|
| Medicare Enrollment ID | O20200420001851 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922424902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A0751476 (California) | Primary |
| Provider Name | Michael Woo-ming |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558623371 PECOS PAC ID: 2062324726 Enrollment ID: I20041005000612 |
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