| Care First Mobile Medical Group Inc | |
|
636 E Broadway Ave 3f Suite 25 San Diego CA 92101 | |
| (858) 769-4400 | |
| (858) 769-4400 |
| Full Name | Care First Mobile Medical Group Inc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 636 E Broadway Ave, San Diego, California |
| Authorized Official Name and Position | Marie Cecille Bawe (CEO) |
| Authorized Official Contact | 6264354344 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Care First Mobile Medical Group Inc 636 E Broadway Ave 3f Suite 25 San Diego CA 92101 Ph: (885) 382-1598 | Care First Mobile Medical Group Inc 636 E Broadway Ave 3f Suite 25 San Diego CA 92101 Ph: (858) 769-4400 |
| NPI Number | 1538871678 |
|---|---|
| Provider Enumeration Date | 12/20/2022 |
| Last Update Date | 10/31/2024 |
| Medicare PECOS PAC ID | 9335597772 |
|---|---|
| Medicare Enrollment ID | O20231127000879 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538871678 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Amable R Aguiluz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1598812596 PECOS PAC ID: 9032000211 Enrollment ID: I20040324001589 |
| Provider Name | William Ang Chua |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639199656 PECOS PAC ID: 1658526082 Enrollment ID: I20130308000401 |
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