| Diabetes Associates Medical Group | |
|
1310 W Stewart Dr Ste 610 Orange CA 92868-3857 | |
| (714) 639-1815 | |
| (714) 638-2374 |
| Full Name | Diabetes Associates Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 1310 W Stewart Dr Ste 610, Orange, California |
| Authorized Official Name and Position | Ivy-joan Madu (PRESIDENT) |
| Authorized Official Contact | 7146391815 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diabetes Associates Medical Group 1310 W Stewart Dr Ste 610 Orange CA 92868-3857 Ph: (714) 639-1815 | Diabetes Associates Medical Group 1310 W Stewart Dr Ste 610 Orange CA 92868-3857 Ph: (714) 639-1815 |
| NPI Number | 1407164460 |
|---|---|
| Provider Enumeration Date | 09/23/2010 |
| Last Update Date | 04/19/2022 |
| Medicare PECOS PAC ID | 4486834835 |
|---|---|
| Medicare Enrollment ID | O20110202000515 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407164460 | NPI | - | NPPES |
| 0A501501 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A50150 (California) | Primary |
| Provider Name | Ivy-joan Madu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710988662 PECOS PAC ID: 0547440992 Enrollment ID: I20110202000551 |
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