| Heart Wellness Clinic Inc. | |
|
112 Harvard Ave Claremont CA 91711-4716 | |
| (909) 757-6561 | |
| (909) 757-6562 |
| Full Name | Heart Wellness Clinic Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 112 Harvard Ave, Claremont, California |
| Authorized Official Name and Position | Barbara Chinedu Amajoyi (CEO) |
| Authorized Official Contact | 9096446444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heart Wellness Clinic Inc. 5050 Juneau Ct Rancho Cucamonga CA 91739-2653 Ph: () - | Heart Wellness Clinic Inc. 112 Harvard Ave Claremont CA 91711-4716 Ph: (909) 757-6561 |
| NPI Number | 1962921981 |
|---|---|
| Provider Enumeration Date | 09/11/2017 |
| Last Update Date | 11/02/2017 |
| Medicare PECOS PAC ID | 3870869829 |
|---|---|
| Medicare Enrollment ID | O20171019001162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962921981 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 18731 (California) | Primary |
| Provider Name | Brian M Tyson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346266269 PECOS PAC ID: 7517921067 Enrollment ID: I20041115001272 |
| Provider Name | Qais Ayouby |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154884351 PECOS PAC ID: 9931582608 Enrollment ID: I20220812000382 |
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