| Corona Doctors Medical Clinic | |
|
802 Magnolia Ave Suite 106 Corona CA 92879-3125 | |
| (951) 371-9500 | |
| (951) 371-9194 |
| Full Name | Corona Doctors Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 802 Magnolia Ave, Corona, California |
| Authorized Official Name and Position | Faro T. Owiesy (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9513719500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Corona Doctors Medical Clinic 802 Magnolia Ave Suite 106 Corona CA 92879-3104 Ph: (951) 371-9500 | Corona Doctors Medical Clinic 802 Magnolia Ave Suite 106 Corona CA 92879-3125 Ph: (951) 371-9500 |
| NPI Number | 1891724886 |
|---|---|
| Provider Enumeration Date | 07/02/2006 |
| Last Update Date | 12/11/2013 |
| Medicare PECOS PAC ID | 0042223661 |
|---|---|
| Medicare Enrollment ID | O20060727000424 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891724886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A87796 (California) | Primary |
| Provider Name | Farough T Owiesy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568464048 PECOS PAC ID: 2668445511 Enrollment ID: I20040818000529 |
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