<unavail> in Victorville, CA - Medicare Internal Medicine

is a medicare enrolled primary clinic (Internal Medicine) in Victorville, California. The current practice location for is 15366 Eleventh St Ste C, Victorville, California. For appointments, you can reach them via phone at (213) 760-3706. The mailing address for is 210 Via Pasqual, Redondo Beach, California and phone number is (213) 760-3706.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1700510518. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (213) 760-3706.

Contact Information


	15366 Eleventh St Ste C Victorville CA 92395-3726
	(213) 760-3706
	(213) 566-3793

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Internal Medicine
Location	15366 Eleventh St Ste C, Victorville, California
Authorized Official Name and Position	John Myung Lee (PRESIDENT)
Authorized Official Contact	2137603706
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
210 Via Pasqual Redondo Beach CA 90277-6655 Ph: (213) 760-3706	15366 Eleventh St Ste C Victorville CA 92395-3726 Ph: (213) 760-3706

NPI Details:

NPI Number	1700510518
Provider Enumeration Date	07/16/2022
Last Update Date	05/22/2023

Medicare PECOS Information:

Medicare PECOS PAC ID	9739545591
Medicare Enrollment ID	O20230519002704

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1700510518	NPI	-	NPPES
1750879755	Medicaid	NY

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	(* (Not Available))	Primary
207RG0300X	Internal Medicine - Geriatric Medicine	(* (Not Available))	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	John Lee
Provider Type	Practitioner - Hospitalist
Provider Identifiers	NPI Number: 1750879755 PECOS PAC ID: 5193060358 Enrollment ID: I20220426000790

Reviews and Comments

Internal Medicine in Victorville, CA

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- Medicare Primary Care in Victorville, CA