| Central Medical Group | |
|
350 S Euclid Ave Ste C Upland CA 91786-6665 | |
| (909) 591-6575 | |
| (909) 591-8986 |
| Full Name | Central Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 350 S Euclid Ave Ste C, Upland, California |
| Authorized Official Name and Position | Nicolaas M Grobler (PRESIDENT/OWNER) |
| Authorized Official Contact | 9095916575 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Medical Group 350 S Euclid Ave Ste C Upland CA 91786-6665 Ph: (909) 591-6575 | Central Medical Group 350 S Euclid Ave Ste C Upland CA 91786-6665 Ph: (909) 591-6575 |
| NPI Number | 1841430535 |
|---|---|
| Provider Enumeration Date | 02/20/2009 |
| Last Update Date | 07/01/2024 |
| Medicare PECOS PAC ID | 7012060189 |
|---|---|
| Medicare Enrollment ID | O20090806000729 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841430535 | NPI | - | NPPES |
| ZZZ58873Y | Other | CA | BLUE SHIELD |
| 1841430535 | Medicaid | CA |
| Provider Name | Nicolaas Grobler |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1720154255 PECOS PAC ID: 8820160880 Enrollment ID: I20090408000008 |
| Provider Name | Khoa Dang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841630019 PECOS PAC ID: 4082848254 Enrollment ID: I20131002000469 |
| Provider Name | Vanessa Valdovinos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356704282 PECOS PAC ID: 6608165584 Enrollment ID: I20160516002357 |
| Provider Name | Melissa Duran Kramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780447706 PECOS PAC ID: 6204378490 Enrollment ID: I20240603003475 |
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