| Couture Medical Group Inc | |
|
6848 Magnolia Ave Suite 230 Riverside CA 92506-2858 | |
| (951) 682-9911 | |
| Not Available |
| Full Name | Couture Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 6848 Magnolia Ave, Riverside, California |
| Authorized Official Name and Position | Larry H Couture (CEO) |
| Authorized Official Contact | 9516829911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Couture Medical Group Inc 6848 Magnolia Ave Suite 230 Riverside CA 92506-2858 Ph: (951) 682-9911 | Couture Medical Group Inc 6848 Magnolia Ave Suite 230 Riverside CA 92506-2858 Ph: (951) 682-9911 |
| NPI Number | 1134528987 |
|---|---|
| Provider Enumeration Date | 08/18/2014 |
| Last Update Date | 09/24/2014 |
| Medicare PECOS PAC ID | 3375866676 |
|---|---|
| Medicare Enrollment ID | O20141217001276 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134528987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Shawn Couture |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548464175 PECOS PAC ID: 3072675602 Enrollment ID: I20081216000473 |
| Provider Name | Carl Wolnisty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912906140 PECOS PAC ID: 3779625090 Enrollment ID: I20100126000161 |
| Provider Name | Jason M Couture |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962609115 PECOS PAC ID: 8325214018 Enrollment ID: I20111230000149 |
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