| Irene Bih Wakam M.d.,a Professional Corporation | |
|
3555 Loma Vista Rd Ste 215 Ventura CA 93003-3161 | |
| (805) 652-1515 | |
| (805) 652-0445 |
| Full Name | Irene Bih Wakam M.d.,a Professional Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 3555 Loma Vista Rd Ste 215, Ventura, California |
| Authorized Official Name and Position | Irene B Wakam (PRESIDENT) |
| Authorized Official Contact | 8056521515 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Irene Bih Wakam M.d.,a Professional Corporation 3555 Loma Vista Rd Ste 215 Ventura CA 93003-3161 Ph: (805) 652-1515 | Irene Bih Wakam M.d.,a Professional Corporation 3555 Loma Vista Rd Ste 215 Ventura CA 93003-3161 Ph: (805) 652-1515 |
| NPI Number | 1952618811 |
|---|---|
| Provider Enumeration Date | 09/13/2010 |
| Last Update Date | 09/13/2010 |
| Medicare PECOS PAC ID | 7517147267 |
|---|---|
| Medicare Enrollment ID | O20110211000793 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952618811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | C50092 (California) | Primary |
| Provider Name | Irene Bih Wakam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568455251 PECOS PAC ID: 6507055910 Enrollment ID: I20110114000640 |
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