| Jamacha Medical Group Inc | |
|
1679 E Main St Suite 206 El Cajon CA 92021-5212 | |
| (619) 579-6300 | |
| (619) 579-0040 |
| Full Name | Jamacha Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1679 E Main St, El Cajon, California |
| Authorized Official Name and Position | Muhammad Anwarul Azam (OWNER) |
| Authorized Official Contact | 6195796300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jamacha Medical Group Inc 1679 E Main St Suite 206 El Cajon CA 92021-5212 Ph: (619) 579-6300 | Jamacha Medical Group Inc 1679 E Main St Suite 206 El Cajon CA 92021-5212 Ph: (619) 579-6300 |
| NPI Number | 1205244738 |
|---|---|
| Provider Enumeration Date | 07/29/2014 |
| Last Update Date | 07/29/2014 |
| Medicare PECOS PAC ID | 1456671866 |
|---|---|
| Medicare Enrollment ID | O20150527001537 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205244738 | NPI | - | NPPES |
| A0052314 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A52314 (California) | Primary |
| Provider Name | Muhammad A Azam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740244367 PECOS PAC ID: 8527213925 Enrollment ID: I20130311000429 |
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