| Heacock Health Medical Group, Inc. | |
|
13939 San Antonio Dr Norwalk CA 90650-4036 | |
| (562) 807-3777 | |
| (562) 807-2333 |
| Full Name | Heacock Health Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 13939 San Antonio Dr, Norwalk, California |
| Authorized Official Name and Position | Rafael A Penunuri (OWNER) |
| Authorized Official Contact | 5627164468 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heacock Health Medical Group, Inc. 13939 San Antonio Dr Norwalk CA 90650-4036 Ph: (562) 807-3777 | Heacock Health Medical Group, Inc. 13939 San Antonio Dr Norwalk CA 90650-4036 Ph: (562) 807-3777 |
| NPI Number | 1851989255 |
|---|---|
| Provider Enumeration Date | 01/02/2021 |
| Last Update Date | 01/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851989255 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207V00000X | Obstetrics & Gynecology | (* (Not Available)) | Secondary |
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