Bristol Plaza Family Medicine | |
3743 So Plaza Drive Santa Ana CA 92704 | |
(714) 332-1800 | |
Not Available |
Full Name | Bristol Plaza Family Medicine |
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Speciality | Family Medicine |
Location | 3743 So Plaza Drive, Santa Ana, California |
Authorized Official Name and Position | John Molina (PRESIDENT) |
Authorized Official Contact | 7143321800 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bristol Plaza Family Medicine 847 Palmyrita Avenue, Suite A Riverside CA 92507 Ph: (951) 784-1400 | Bristol Plaza Family Medicine 3743 So Plaza Drive Santa Ana CA 92704 Ph: (714) 332-1800 |
NPI Number | 1598165201 |
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Provider Enumeration Date | 08/29/2014 |
Last Update Date | 05/28/2015 |
Medicare PECOS PAC ID | 5294054920 |
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Medicare Enrollment ID | O20150501000248 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598165201 | NPI | - | NPPES |
20A7903 | Other | CA | MEDICAL LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (California) | Primary |
Provider Name | John M Molina |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1770547523 PECOS PAC ID: 5496735755 Enrollment ID: I20040809001234 |
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