| Cm Providers Medical Group, Pc | |
|
1501 Superior Ave Ste 205 Newport Beach CA 92663-3640 | |
| (866) 433-9943 | |
| (657) 226-2907 |
| Full Name | Cm Providers Medical Group, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1501 Superior Ave Ste 205, Newport Beach, California |
| Authorized Official Name and Position | Tarun Marwaha (PRESIDENT) |
| Authorized Official Contact | 8664339943 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cm Providers Medical Group, Pc 625 The City Dr S Ste 310 Orange CA 92868-4949 Ph: (866) 433-9943 | Cm Providers Medical Group, Pc 1501 Superior Ave Ste 205 Newport Beach CA 92663-3640 Ph: (866) 433-9943 |
| NPI Number | 1497444905 |
|---|---|
| Provider Enumeration Date | 05/02/2023 |
| Last Update Date | 08/31/2023 |
| Medicare PECOS PAC ID | 5294196994 |
|---|---|
| Medicare Enrollment ID | O20230727002167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497444905 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| Provider Name | Eric Alan Wechsler |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1659469526 PECOS PAC ID: 9638261464 Enrollment ID: I20070823000771 |
| Provider Name | Tarun Marwaha |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1407964976 PECOS PAC ID: 9739272337 Enrollment ID: I20080522000621 |
| Provider Name | Brian Y Park |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548609241 PECOS PAC ID: 7618251141 Enrollment ID: I20170301002106 |
| Provider Name | Deborah P Harrop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649925421 PECOS PAC ID: 8820484397 Enrollment ID: I20220408002126 |
| Provider Name | Erika Marie Green |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1922156322 PECOS PAC ID: 1658743646 Enrollment ID: I20230222001961 |
| Provider Name | Joyce Jimenez Atkins |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1952810236 PECOS PAC ID: 9234502048 Enrollment ID: I20230227000454 |
| Provider Name | Heather Lynn Mcisaac |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861022824 PECOS PAC ID: 4981053006 Enrollment ID: I20231213003963 |
| Provider Name | Gabriela Villafuerte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659020550 PECOS PAC ID: 4587009766 Enrollment ID: I20240227003659 |
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