| Khemara Family Medical Clinic Inc. | |
|
440 Redondo Ave Ste 201 Long Beach CA 90814-5145 | |
| (562) 439-3803 | |
| (866) 593-7781 |
| Full Name | Khemara Family Medical Clinic Inc. |
|---|---|
| Speciality | General Practice |
| Location | 440 Redondo Ave Ste 201, Long Beach, California |
| Authorized Official Name and Position | Nagasamudra S. Ashok (SOLE PROPRIETOR) |
| Authorized Official Contact | 5624393803 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Khemara Family Medical Clinic Inc. 440 Redondo Ave Ste 201 Long Beach CA 90814-5145 Ph: (562) 439-3803 | Khemara Family Medical Clinic Inc. 440 Redondo Ave Ste 201 Long Beach CA 90814-5145 Ph: (562) 439-3803 |
| NPI Number | 1508296146 |
|---|---|
| Provider Enumeration Date | 11/18/2013 |
| Last Update Date | 12/17/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508296146 | NPI | - | NPPES |
| A41589 | Other | CA | MEDICAL LICENSE |
| 10940873 | Other | CA | CAQA PROVIDER ENROLLMENT |
| ZZZ58486Y | Other | CA | BLUE SHIELD PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A41589 (California) | Primary |
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