| Infectious Disease Consultants Med. Office, Inc. | |
|
1275 N. Rose Drive Suite 134 Placentia CA 92870-3919 | |
| (714) 996-6500 | |
| (714) 996-1722 |
| Full Name | Infectious Disease Consultants Med. Office, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1275 N. Rose Drive, Placentia, California |
| Authorized Official Name and Position | Joel A. Trotter (PRESIDENT) |
| Authorized Official Contact | 7149966500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infectious Disease Consultants Med. Office, Inc. 1275 N. Rose Drive Suite 134 Placentia CA 92870-3919 Ph: (714) 996-6500 | Infectious Disease Consultants Med. Office, Inc. 1275 N. Rose Drive Suite 134 Placentia CA 92870-3919 Ph: (714) 996-6500 |
| NPI Number | 1912062647 |
|---|---|
| Provider Enumeration Date | 12/22/2006 |
| Last Update Date | 11/04/2019 |
| Medicare PECOS PAC ID | 7315026309 |
|---|---|
| Medicare Enrollment ID | O20080501000541 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912062647 | NPI | - | NPPES |
| W15729 | Other | PROVIDER IDENTIFICATION NUMBER | |
| GR0048130 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | G65207 (California) | Primary |
| Provider Name | Bhanu Sud |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1972643344 PECOS PAC ID: 8325127319 Enrollment ID: I20080501000518 |
| Provider Name | Pauline Ho |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1194854794 PECOS PAC ID: 8224109376 Enrollment ID: I20101004000268 |
| Provider Name | Joel A. Trotter |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1578690343 PECOS PAC ID: 7315018462 Enrollment ID: I20101103001030 |
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Centers Of Rehabilitation & Pain Medicine Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1041 E Yorba Linda Blvd Ste 210, Placentia, CA 92870 Phone: 714-223-7000 Fax: 833-471-2059 | |
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