Fcs Medical Corporation | |
1701 E Cesar Chavez Avenue Suite 402 Los Angeles CA 90033-2496 | |
(323) 317-9200 | |
(323) 317-9206 |
Full Name | Fcs Medical Corporation |
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Speciality | Family Medicine |
Location | 1701 E Cesar Chavez Avenue, Los Angeles, California |
Authorized Official Name and Position | Luis Ramon Samaniego (GROUP PRESIDENT) |
Authorized Official Contact | 3232555643 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Fcs Medical Corporation 5823 York Blvd Suite 3 Los Angeles CA 90042-2634 Ph: (323) 317-9200 | Fcs Medical Corporation 1701 E Cesar Chavez Avenue Suite 402 Los Angeles CA 90033-2496 Ph: (323) 317-9200 |
NPI Number | 1649223777 |
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Provider Enumeration Date | 05/18/2006 |
Last Update Date | 03/16/2010 |
Medicare PECOS PAC ID | 6709834112 |
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Medicare Enrollment ID | O20050111001140 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649223777 | NPI | - | NPPES |
CQ2165 | Other | GA | RAILROAD MEDICARE GROUP |
GR0040674 | Other | CA | MEDICAID GROUP ID |
ZZZ56170Z | Other | CA | BLUE SHIELD GROUP ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Ana Bertha Pantoja |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1164593877 PECOS PAC ID: 8123057080 Enrollment ID: I20050810001101 |
Provider Name | Maria Cynthia S Lopez |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1205888922 PECOS PAC ID: 1254346430 Enrollment ID: I20060208000753 |
Provider Name | Jorge Martinez |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1164475588 PECOS PAC ID: 0941216949 Enrollment ID: I20060228000775 |
Provider Name | Armando Pacheco |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1336198605 PECOS PAC ID: 3476565441 Enrollment ID: I20060613000195 |
Provider Name | Lucila Tarin |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1568417616 PECOS PAC ID: 1052400793 Enrollment ID: I20071204000419 |
Provider Name | Christopher M Hiromura |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1124213475 PECOS PAC ID: 1850451881 Enrollment ID: I20081120000909 |
Provider Name | Andrew S Chan |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1104975507 PECOS PAC ID: 5092839191 Enrollment ID: I20100826000163 |
Provider Name | Hector Flores |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1124070578 PECOS PAC ID: 7416073523 Enrollment ID: I20100927000734 |
Provider Name | Luis R Samaniego |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1821055369 PECOS PAC ID: 0547386419 Enrollment ID: I20100928001405 |
Provider Name | Mauricio E Bueno |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750332029 PECOS PAC ID: 8527016930 Enrollment ID: I20100928001473 |
Provider Name | David Sulam |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1124073374 PECOS PAC ID: 1153447073 Enrollment ID: I20100929000211 |
Provider Name | Daniel C Maldonado |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1851344949 PECOS PAC ID: 3779609698 Enrollment ID: I20100929000232 |
Provider Name | Hector A Gonzalez |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1407813322 PECOS PAC ID: 3577689496 Enrollment ID: I20100929000265 |
Provider Name | Edward Castro |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750330817 PECOS PAC ID: 9638295553 Enrollment ID: I20100929000294 |
Provider Name | Sergio B Villegas |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1063463339 PECOS PAC ID: 6406040476 Enrollment ID: I20101103000980 |
Provider Name | Nazareth H Way |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598068074 PECOS PAC ID: 5193906543 Enrollment ID: I20110218000317 |
Provider Name | Morodak Meas |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1124252366 PECOS PAC ID: 6204092653 Enrollment ID: I20120730000427 |
Provider Name | Teresa T Ku-borden |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1962722660 PECOS PAC ID: 4183873854 Enrollment ID: I20121012000777 |
Provider Name | Parth S Rajyaguru |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1205153525 PECOS PAC ID: 8628211141 Enrollment ID: I20141110001127 |
Provider Name | Nisha Jain Agrawal |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1427374321 PECOS PAC ID: 5092958785 Enrollment ID: I20141126001586 |
Provider Name | Geny B Zapata |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1417155367 PECOS PAC ID: 8820311632 Enrollment ID: I20150102000138 |
Provider Name | Kathleen Constantino |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487201083 PECOS PAC ID: 3577990043 Enrollment ID: I20200221001424 |
Provider Name | Yeri Park |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1942730791 PECOS PAC ID: 8123398682 Enrollment ID: I20210923002192 |
Provider Name | Jessica Gonzalez Haugen |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1487215372 PECOS PAC ID: 8022484518 Enrollment ID: I20221025002552 |
Provider Name | Daniel Joongoo Lee |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1770106478 PECOS PAC ID: 9234590175 Enrollment ID: I20230725003267 |
Provider Name | Janel Gracia |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1619591989 PECOS PAC ID: 6507220688 Enrollment ID: I20230907002012 |
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