| Centric Healthcare, A Professional Corporation | |
|
506 W Valley Blvd Ste 300 San Gabriel CA 91776-5716 | |
| (626) 288-8288 | |
| (626) 288-9488 |
| Full Name | Centric Healthcare, A Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 506 W Valley Blvd Ste 300, San Gabriel, California |
| Authorized Official Name and Position | Prudence Lu (CLINICAL DIRECTOR) |
| Authorized Official Contact | 6262888288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centric Healthcare, A Professional Corporation 506 W Valley Blvd Ste 300 San Gabriel CA 91776-5716 Ph: (626) 288-8288 | Centric Healthcare, A Professional Corporation 506 W Valley Blvd Ste 300 San Gabriel CA 91776-5716 Ph: (626) 288-8288 |
| NPI Number | 1295345882 |
|---|---|
| Provider Enumeration Date | 08/07/2020 |
| Last Update Date | 08/07/2020 |
| Medicare PECOS PAC ID | 8921426529 |
|---|---|
| Medicare Enrollment ID | O20200914002710 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295345882 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Stanley K Lau |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548222813 PECOS PAC ID: 3476566977 Enrollment ID: I20060731000313 |
| Provider Name | Prudence Lu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720416704 PECOS PAC ID: 9638492390 Enrollment ID: I20150105000467 |
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