| Heba Boshra Md, Inc. | |
|
5900 Brockton Ave Riverside CA 92506-1862 | |
| (909) 226-0198 | |
| Not Available |
| Full Name | Heba Boshra Md, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 5900 Brockton Ave, Riverside, California |
| Authorized Official Name and Position | Heba Boshra (MD) |
| Authorized Official Contact | 9092260198 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heba Boshra Md, Inc. 6971 Russian River Ct Rancho Cucamonga CA 91739-2063 Ph: (909) 226-0198 | Heba Boshra Md, Inc. 5900 Brockton Ave Riverside CA 92506-1862 Ph: (909) 226-0198 |
| NPI Number | 1891212296 |
|---|---|
| Provider Enumeration Date | 08/25/2017 |
| Last Update Date | 08/25/2017 |
| Medicare PECOS PAC ID | 6406112085 |
|---|---|
| Medicare Enrollment ID | O20171206002209 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891212296 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A120531 (California) | Primary |
| Provider Name | Heba A Boshra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942575022 PECOS PAC ID: 0143473348 Enrollment ID: I20130122000464 |
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