| Family Associated Medical Group Inc. | |
|
767 S Sunset Ave Suite #4 West Covina CA 91790-3546 | |
| (626) 337-7204 | |
| (626) 851-1855 |
| Full Name | Family Associated Medical Group Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 767 S Sunset Ave, West Covina, California |
| Authorized Official Name and Position | John C Koumas (OWNER) |
| Authorized Official Contact | 6263377204 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Associated Medical Group Inc. 767 S Sunset Ave Suite #4 West Covina CA 91790-3546 Ph: (626) 337-7204 | Family Associated Medical Group Inc. 767 S Sunset Ave Suite #4 West Covina CA 91790-3546 Ph: (626) 337-7204 |
| NPI Number | 1083782122 |
|---|---|
| Provider Enumeration Date | 11/30/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8729049986 |
|---|---|
| Medicare Enrollment ID | O20041020001396 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083782122 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20A5515 (California) | Primary |
| Provider Name | John C Koumas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134111958 PECOS PAC ID: 4981665379 Enrollment ID: I20041020001393 |
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