| George Umaguing Suyat, Md, Inc. | |
|
2105 Beverly Blvd Suite 131 Los Angeles CA 90057-2216 | |
| (213) 413-8836 | |
| (213) 413-2616 |
| Full Name | George Umaguing Suyat, Md, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2105 Beverly Blvd, Los Angeles, California |
| Authorized Official Name and Position | George Umaguing Suyat (PRESIDENT) |
| Authorized Official Contact | 2134138836 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| George Umaguing Suyat, Md, Inc. 2105 Beverly Blvd Suite 131 Los Angeles CA 90057-2216 Ph: (213) 413-8836 | George Umaguing Suyat, Md, Inc. 2105 Beverly Blvd Suite 131 Los Angeles CA 90057-2216 Ph: (213) 413-8836 |
| NPI Number | 1801063300 |
|---|---|
| Provider Enumeration Date | 05/14/2008 |
| Last Update Date | 05/14/2008 |
| Medicare PECOS PAC ID | 8820113368 |
|---|---|
| Medicare Enrollment ID | O20100921000419 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801063300 | NPI | - | NPPES |
| 00A521060 | Medicaid | CA | |
| 1023047669 | Other | CA | INDIVIDUAL NP1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A52106 (California) | Primary |
| Provider Name | George Umaguing Suyat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023047669 PECOS PAC ID: 9739204272 Enrollment ID: I20100921000444 |
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