| La Puente Valley Medical Group Inc | |
|
18335 Valley Blvd La Puente CA 91744-5968 | |
| (626) 810-3330 | |
| (626) 964-0440 |
| Full Name | La Puente Valley Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 18335 Valley Blvd, La Puente, California |
| Authorized Official Name and Position | Hiren C Shah (PRESIDENT) |
| Authorized Official Contact | 6268103330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Puente Valley Medical Group Inc 18335 Valley Blvd La Puente CA 91744-5968 Ph: (626) 810-3330 | La Puente Valley Medical Group Inc 18335 Valley Blvd La Puente CA 91744-5968 Ph: (626) 810-3330 |
| NPI Number | 1639270093 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0042240145 |
|---|---|
| Medicare Enrollment ID | O20050818000311 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639270093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Hiren C Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578664934 PECOS PAC ID: 5092819573 Enrollment ID: I20070323000221 |
| Provider Name | Marcela A Montes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710161443 PECOS PAC ID: 2264562461 Enrollment ID: I20100615000508 |
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