| John J. Kane, M.d.,inc | |
|
4646 Brockton Ave 301 Riverside CA 92506-0102 | |
| (951) 774-2932 | |
| (951) 774-2935 |
| Full Name | John J. Kane, M.d.,inc |
|---|---|
| Speciality | Family Medicine |
| Location | 4646 Brockton Ave, Riverside, California |
| Authorized Official Name and Position | John J Kane (M.D.) |
| Authorized Official Contact | 9517742932 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John J. Kane, M.d.,inc 4646 Brockton Ave 301 Riverside CA 92506-0102 Ph: (951) 774-2932 | John J. Kane, M.d.,inc 4646 Brockton Ave 301 Riverside CA 92506-0102 Ph: (951) 774-2932 |
| NPI Number | 1508060211 |
|---|---|
| Provider Enumeration Date | 06/14/2007 |
| Last Update Date | 08/08/2022 |
| Medicare PECOS PAC ID | 8628169521 |
|---|---|
| Medicare Enrollment ID | O20070807000526 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508060211 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G28777 (California) | Primary |
| Provider Name | John J Kane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326035593 PECOS PAC ID: 6800796582 Enrollment ID: I20070807000523 |
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