| Bolsa-ward Medical Clinic, Inc. | |
|
13872 Harbor Blvd Unit 1c Garden Grove CA 92843-4000 | |
| (714) 531-5201 | |
| (714) 775-2849 |
| Full Name | Bolsa-ward Medical Clinic, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 13872 Harbor Blvd, Garden Grove, California |
| Authorized Official Name and Position | Phu Van Dang (PRESIDENT) |
| Authorized Official Contact | 7145315201 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bolsa-ward Medical Clinic, Inc. 13872 Harbor Blvd Unit 1c Garden Grove CA 92843-4000 Ph: (714) 531-5201 | Bolsa-ward Medical Clinic, Inc. 13872 Harbor Blvd Unit 1c Garden Grove CA 92843-4000 Ph: (714) 531-5201 |
| NPI Number | 1093918872 |
|---|---|
| Provider Enumeration Date | 06/07/2007 |
| Last Update Date | 05/20/2014 |
| Medicare PECOS PAC ID | 6103864780 |
|---|---|
| Medicare Enrollment ID | O20050422001233 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093918872 | NPI | - | NPPES |
| Provider Name | An Quoc Dang |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1952302564 PECOS PAC ID: 0941474043 Enrollment ID: I20120106000208 |
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