| Emmanuel Medical Providers | |
|
9675 Monte Vista Ave Ste B Montclair CA 91763-2213 | |
| (909) 447-5554 | |
| (909) 447-5582 |
| Full Name | Emmanuel Medical Providers |
|---|---|
| Speciality | Family Medicine |
| Location | 9675 Monte Vista Ave, Montclair, California |
| Authorized Official Name and Position | Dee Beng K Lim (CEO) |
| Authorized Official Contact | 9094475554 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emmanuel Medical Providers 9675 Monte Vista Ave Ste B Montclair CA 91763-2213 Ph: (909) 447-5554 | Emmanuel Medical Providers 9675 Monte Vista Ave Ste B Montclair CA 91763-2213 Ph: (909) 447-5554 |
| NPI Number | 1992760417 |
|---|---|
| Provider Enumeration Date | 04/18/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992760417 | NPI | - | NPPES |
| 00C399801 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | C39980 (California) | Primary |
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