| Ebtissam H Korkis Md Inc | |
|
1530 Jamacha Rd Ste E-f El Cajon CA 92019-3700 | |
| (619) 441-9200 | |
| (619) 441-0710 |
| Full Name | Ebtissam H Korkis Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1530 Jamacha Rd Ste E-f, El Cajon, California |
| Authorized Official Name and Position | Ebtissam H. Korkis (AUTHORIZED OFFICAL/PRESIDENT) |
| Authorized Official Contact | 6194419200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ebtissam H Korkis Md Inc 1530 Jamacha Rd Ste E-f El Cajon CA 92019-3700 Ph: (619) 441-9200 | Ebtissam H Korkis Md Inc 1530 Jamacha Rd Ste E-f El Cajon CA 92019-3700 Ph: (619) 441-9200 |
| NPI Number | 1144732595 |
|---|---|
| Provider Enumeration Date | 10/25/2017 |
| Last Update Date | 06/16/2018 |
| Medicare PECOS PAC ID | 9638436272 |
|---|---|
| Medicare Enrollment ID | O20171206002105 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144732595 | NPI | - | NPPES |
| 00A897670 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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