| Gateway Medicor - Rancho Cucamonga Inc. | |
|
10995 Eucalyptus St Ste 102 Rancho Cucamonga CA 91730-7687 | |
| (800) 708-3230 | |
| Not Available |
| Full Name | Gateway Medicor - Rancho Cucamonga Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 10995 Eucalyptus St Ste 102, Rancho Cucamonga, California |
| Authorized Official Name and Position | Robert Elders (SECRETARY) |
| Authorized Official Contact | 7147881249 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Medicor - Rancho Cucamonga Inc. 600 City Pkwy W Fl 10 Orange CA 92868-2968 Ph: (800) 708-3230 | Gateway Medicor - Rancho Cucamonga Inc. 10995 Eucalyptus St Ste 102 Rancho Cucamonga CA 91730-7687 Ph: (800) 708-3230 |
| NPI Number | 1932974896 |
|---|---|
| Provider Enumeration Date | 11/21/2023 |
| Last Update Date | 02/14/2024 |
| Medicare PECOS PAC ID | 3476994666 |
|---|---|
| Medicare Enrollment ID | O20240520001140 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932974896 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Mark Laurence Shiu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629004478 PECOS PAC ID: 6608882709 Enrollment ID: I20150413001265 |
Carlos R. Vigil, D.o. (a Professional Corporation) Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7974 Haven Ave, Suite 210, Rancho Cucamonga, CA 91730 Phone: 909-941-0661 Fax: 909-948-5577 | |
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Prohealth Partners A Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8008 Haven Ave Ste 100, Rancho Cucamonga, CA 91730 Phone: 909-483-1236 Fax: 909-344-3910 | |
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