| Interventional Gastroenterology Consultants A Medical Corporation | |
|
4845 Via Del Cerro Yorba Linda CA 92887-2641 | |
| (714) 305-9507 | |
| (888) 818-3162 |
| Full Name | Interventional Gastroenterology Consultants A Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 4845 Via Del Cerro, Yorba Linda, California |
| Authorized Official Name and Position | Liz Shepherd (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 9512564360 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Interventional Gastroenterology Consultants A Medical Corporation 4845 Via Del Cerro Yorba Linda CA 92887-2641 Ph: (714) 305-9507 | Interventional Gastroenterology Consultants A Medical Corporation 4845 Via Del Cerro Yorba Linda CA 92887-2641 Ph: (714) 305-9507 |
| NPI Number | 1508556465 |
|---|---|
| Provider Enumeration Date | 05/12/2023 |
| Last Update Date | 05/12/2023 |
| Medicare PECOS PAC ID | 4284088840 |
|---|---|
| Medicare Enrollment ID | O20230929003172 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508556465 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | John Jaewoo Kim |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1467676460 PECOS PAC ID: 8820144595 Enrollment ID: I20090922000164 |
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