| Irvine Professional Medical Group | |
|
3500 Barranca Pkwy 330 Irvine CA 92606-8226 | |
| (949) 552-8217 | |
| (949) 809-9514 |
| Full Name | Irvine Professional Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 3500 Barranca Pkwy, Irvine, California |
| Authorized Official Name and Position | Moonmock Oh (PRESIDENT) |
| Authorized Official Contact | 9495528217 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Irvine Professional Medical Group 3500 Barranca Pkwy 330 Irvine CA 92606-8226 Ph: (949) 552-8217 | Irvine Professional Medical Group 3500 Barranca Pkwy 330 Irvine CA 92606-8226 Ph: (949) 552-8217 |
| NPI Number | 1174756357 |
|---|---|
| Provider Enumeration Date | 09/03/2009 |
| Last Update Date | 04/14/2014 |
| Medicare PECOS PAC ID | 9638217318 |
|---|---|
| Medicare Enrollment ID | O20091118000169 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174756357 | NPI | - | NPPES |
| A107209 | Other | CA | MEDICAL BOARD OF CALIFORNIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A107209 (California) | Primary |
| Provider Name | Moon Mock Oh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902838881 PECOS PAC ID: 2365580040 Enrollment ID: I20091118000178 |
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