| Humanicare, Inc. | |
|
13920 City Center Dr Ste 290 Chino Hills CA 91709-5444 | |
| (909) 973-7772 | |
| Not Available |
| Full Name | Humanicare, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 13920 City Center Dr Ste 290, Chino Hills, California |
| Authorized Official Name and Position | Petter Mattar (PRESIDENT) |
| Authorized Official Contact | 9099737772 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Humanicare, Inc. 15076 Canon Ln Chino Hills CA 91709-5211 Ph: () - | Humanicare, Inc. 13920 City Center Dr Ste 290 Chino Hills CA 91709-5444 Ph: (909) 973-7772 |
| NPI Number | 1639672470 |
|---|---|
| Provider Enumeration Date | 03/16/2018 |
| Last Update Date | 03/16/2018 |
| Medicare PECOS PAC ID | 0941564470 |
|---|---|
| Medicare Enrollment ID | O20180508002157 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639672470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A97235 (California) | Primary |
| Provider Name | Peter Mattar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417005422 PECOS PAC ID: 8426147398 Enrollment ID: I20071129000341 |
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