| Crestpoint Medical Group Inc | |
|
1611 Pomona Rd # 235 Corona CA 92878-4324 | |
| (909) 757-8668 | |
| Not Available |
| Full Name | Crestpoint Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1611 Pomona Rd # 235, Corona, California |
| Authorized Official Name and Position | Anthony Ogugu (NURSE PRACTITIONER) |
| Authorized Official Contact | 9097578668 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crestpoint Medical Group Inc 1611 Pomona Rd # 235 Corona CA 92878-4324 Ph: () - | Crestpoint Medical Group Inc 1611 Pomona Rd # 235 Corona CA 92878-4324 Ph: (909) 757-8668 |
| NPI Number | 1184458408 |
|---|---|
| Provider Enumeration Date | 08/28/2024 |
| Last Update Date | 10/01/2024 |
| Medicare PECOS PAC ID | 2860923828 |
|---|---|
| Medicare Enrollment ID | O20241001002221 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184458408 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Valentine Ugwumba Otuechere |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508896275 PECOS PAC ID: 4486790102 Enrollment ID: I20091012000198 |
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