| Family & Preventive Medical Center Of Chula Vista A Medical Corporatio | |
|
1415 Ridgeback Rd #4 Chula Vista CA 91910-6932 | |
| (619) 421-4257 | |
| (619) 421-6913 |
| Full Name | Family & Preventive Medical Center Of Chula Vista A Medical Corporatio |
|---|---|
| Speciality | Family Medicine |
| Location | 1415 Ridgeback Rd, Chula Vista, California |
| Authorized Official Name and Position | Kevin A Malone (PRESIDENT) |
| Authorized Official Contact | 6194214257 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family & Preventive Medical Center Of Chula Vista A Medical Corporatio 1415 Ridgeback Rd #4 Chula Vista CA 91910-6932 Ph: (619) 421-4257 | Family & Preventive Medical Center Of Chula Vista A Medical Corporatio 1415 Ridgeback Rd #4 Chula Vista CA 91910-6932 Ph: (619) 421-4257 |
| NPI Number | 1538223813 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 12/29/2015 |
| Medicare PECOS PAC ID | 4880638865 |
|---|---|
| Medicare Enrollment ID | O20080116000859 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538223813 | NPI | - | NPPES |
| W14157 | Other | CA | MEDICARE ID-TYPE UNSPECI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G46053 (California) | Primary |
| Provider Name | Kevin A Malone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053389361 PECOS PAC ID: 7315028206 Enrollment ID: I20100212000338 |
| Provider Name | Belen M Sarwacinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730394990 PECOS PAC ID: 6305160433 Enrollment ID: I20150121000966 |
| Provider Name | Romeo Andrew Virrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285122721 PECOS PAC ID: 0840676268 Enrollment ID: I20221007000893 |
| Provider Name | Opalyn P Olmedo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356064463 PECOS PAC ID: 4486022688 Enrollment ID: I20221118001959 |
Robert H Moon Md, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1030 White Alder Ave, Chula Vista, CA 91914 Phone: 619-800-6713 Fax: 619-503-9000 | |
Leticia Uwedjojevwe Md Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 340 4th Ave Ste 10, Chula Vista, CA 91910 Phone: 619-934-2215 Fax: 619-934-2340 | |
Chula Vista Family Counseling Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 248 Landis Ave, Chula Vista, CA 91910 Phone: 619-515-2562 Fax: 619-269-0115 | |
Centro De Salud De La Comunidad De San Ysidro Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1061 Tierra Del Rey, Ste 303, 304, 305, Chula Vista, CA 91910 Phone: 619-662-4100 | |
Landis Avenue Family Counseling Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 264 Landis Ave Ste 100, Chula Vista, CA 91910 Phone: 619-906-5383 Fax: 619-237-1856 | |
Sharna B Shachar M D A Professional Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 525 H St, Chula Vista, CA 91910 Phone: 619-409-9999 Fax: 619-409-9905 | |
Operation Samahan Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 480 4th Ave Ste 401, Chula Vista, CA 91910 Phone: 844-200-2426 Fax: 619-356-2726 |