| Centro Medico Community Clinic Inc | |
|
1303 W 6th St Ste 105 Corona CA 92882-3196 | |
| (951) 278-8910 | |
| Not Available |
| Full Name | Centro Medico Community Clinic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1303 W 6th St Ste 105, Corona, California |
| Authorized Official Name and Position | Samar Masri (HR/FINANCIAL COORDINATOR) |
| Authorized Official Contact | 9092416861 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centro Medico Community Clinic Inc 1303 W 6th St Ste 102 Corona CA 92882-3196 Ph: (951) 376-3097 | Centro Medico Community Clinic Inc 1303 W 6th St Ste 105 Corona CA 92882-3196 Ph: (951) 278-8910 |
| NPI Number | 1386298008 |
|---|---|
| Provider Enumeration Date | 07/31/2019 |
| Last Update Date | 01/25/2022 |
| Medicare PECOS PAC ID | 9436398138 |
|---|---|
| Medicare Enrollment ID | O20210824002955 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386298008 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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