| Jose M. Pavia, Md, Inc. | |
|
13768 Roswell Ave Suite 101 Chino CA 91710-1401 | |
| (909) 517-2188 | |
| (909) 517-1598 |
| Full Name | Jose M. Pavia, Md, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 13768 Roswell Ave, Chino, California |
| Authorized Official Name and Position | Jose M. Pavia (MD/PRESIDENT) |
| Authorized Official Contact | 9095172188 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jose M. Pavia, Md, Inc. 13768 Roswell Ave Suite 101 Chino CA 91710-1401 Ph: (909) 517-2188 | Jose M. Pavia, Md, Inc. 13768 Roswell Ave Suite 101 Chino CA 91710-1401 Ph: (909) 517-2188 |
| NPI Number | 1366511370 |
|---|---|
| Provider Enumeration Date | 11/06/2006 |
| Last Update Date | 08/24/2010 |
| Medicare PECOS PAC ID | 6608970421 |
|---|---|
| Medicare Enrollment ID | O20070403000406 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366511370 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | C43068 (California) | Primary |
| Provider Name | Jose M Pavia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447251145 PECOS PAC ID: 9234038241 Enrollment ID: I20040107001024 |
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