| Family Medicine Headquarters, Inc | |
|
521 N Azusa Ave Azusa CA 91702-2936 | |
| (626) 334-4061 | |
| (626) 334-6828 |
| Full Name | Family Medicine Headquarters, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 521 N Azusa Ave, Azusa, California |
| Authorized Official Name and Position | Shariar Borbor (PRESIDENT / MEDICAL DIRECTOR) |
| Authorized Official Contact | 6263344061 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Headquarters, Inc 1014 Broadway # 617 Santa Monica CA 90401-2808 Ph: (626) 334-4061 | Family Medicine Headquarters, Inc 521 N Azusa Ave Azusa CA 91702-2936 Ph: (626) 334-4061 |
| NPI Number | 1740757996 |
|---|---|
| Provider Enumeration Date | 10/25/2018 |
| Last Update Date | 05/22/2024 |
| Medicare PECOS PAC ID | 8628305588 |
|---|---|
| Medicare Enrollment ID | O20190815000261 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740757996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Shariar Borbor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477868933 PECOS PAC ID: 4284863499 Enrollment ID: I20140211001413 |
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