| Clinica Medica Familiar De Montclair | |
|
10563 Mills Ave Montclair CA 91763-4610 | |
| (909) 626-4020 | |
| Not Available |
| Full Name | Clinica Medica Familiar De Montclair |
|---|---|
| Speciality | Family Medicine |
| Location | 10563 Mills Ave, Montclair, California |
| Authorized Official Name and Position | Octavio Ruiz-villalpando (PRESIDENT) |
| Authorized Official Contact | 9096264020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica Medica Familiar De Montclair 10563 Mills Ave Montclair CA 91763-4610 Ph: (909) 262-4020 | Clinica Medica Familiar De Montclair 10563 Mills Ave Montclair CA 91763-4610 Ph: (909) 626-4020 |
| NPI Number | 1568567600 |
|---|---|
| Provider Enumeration Date | 09/13/2006 |
| Last Update Date | 12/01/2008 |
| Medicare PECOS PAC ID | 6204932429 |
|---|---|
| Medicare Enrollment ID | O20070504000393 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568567600 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A92039 (California) | Primary |
| Provider Name | Octavio Ruiz Villalpando |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194832816 PECOS PAC ID: 3870691926 Enrollment ID: I20070613000358 |
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