| California Medical Clinic Inc. | |
|
402 E Holt Blvd Ontario CA 91761-1618 | |
| (909) 467-1605 | |
| (909) 467-1608 |
| Full Name | California Medical Clinic Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 402 E Holt Blvd, Ontario, California |
| Authorized Official Name and Position | Leland Mathew Luna (PRESIDENT) |
| Authorized Official Contact | 9094671605 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| California Medical Clinic Inc. 402 E Holt Blvd Ontario CA 91761-1618 Ph: (909) 467-1605 | California Medical Clinic Inc. 402 E Holt Blvd Ontario CA 91761-1618 Ph: (909) 467-1605 |
| NPI Number | 1043242142 |
|---|---|
| Provider Enumeration Date | 07/07/2006 |
| Last Update Date | 09/18/2008 |
| Medicare PECOS PAC ID | 9537101134 |
|---|---|
| Medicare Enrollment ID | O20050524000903 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043242142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | David Lozano |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1104041995 PECOS PAC ID: 8123060605 Enrollment ID: I20050525000222 |
| Provider Name | Soledad S Reyes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790900595 PECOS PAC ID: 3577651322 Enrollment ID: I20071113000326 |
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