| Great Care Medical Group | |
|
2221 Lincoln Blvd Suite 200 Santa Monica CA 90405-1320 | |
| (310) 396-9999 | |
| (310) 664-8901 |
| Full Name | Great Care Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 2221 Lincoln Blvd, Santa Monica, California |
| Authorized Official Name and Position | Benjamin Behroozan (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3103969999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Care Medical Group 2221 Lincoln Blvd Suite 200 Santa Monica CA 90405-1320 Ph: (310) 396-9999 | Great Care Medical Group 2221 Lincoln Blvd Suite 200 Santa Monica CA 90405-1320 Ph: (310) 396-9999 |
| NPI Number | 1639234362 |
|---|---|
| Provider Enumeration Date | 12/22/2006 |
| Last Update Date | 07/18/2011 |
| Medicare PECOS PAC ID | 3870544034 |
|---|---|
| Medicare Enrollment ID | O20050204000133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639234362 | NPI | - | NPPES |
| GR0026800 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A41374 (California) | Primary |
| Provider Name | Parviz Javdan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376640235 PECOS PAC ID: 6204827629 Enrollment ID: I20051024000769 |
| Provider Name | Benjamin Behroozan |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1750440681 PECOS PAC ID: 8325099583 Enrollment ID: I20051209000359 |
Vitality&longevity Medical Center A Professional Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2221 Lincoln Blvd, Suite 200, Santa Monica, CA 90405 Phone: 310-581-8585 Fax: 320-215-4650 | |
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