| Libra Pain Care | |
|
1433 W Merced Ave Ste 311 West Covina CA 91790 | |
| (626) 506-2648 | |
| (626) 898-9250 |
| Full Name | Libra Pain Care |
|---|---|
| Speciality | Pain Medicine |
| Location | 1433 W Merced Ave Ste 311, West Covina, California |
| Authorized Official Name and Position | Sam Ahdab (PRESIDENT) |
| Authorized Official Contact | 3232172856 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Libra Pain Care 1433 W Merced Ave Ste 311 West Covina CA 91790-3402 Ph: (626) 506-2648 | Libra Pain Care 1433 W Merced Ave Ste 311 West Covina CA 91790 Ph: (626) 506-2648 |
| NPI Number | 1477952117 |
|---|---|
| Provider Enumeration Date | 08/19/2014 |
| Last Update Date | 07/26/2018 |
| Medicare PECOS PAC ID | 9931417805 |
|---|---|
| Medicare Enrollment ID | O20150928000799 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477952117 | NPI | - | NPPES |
| Provider Name | Sam Ahdab |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1992941397 PECOS PAC ID: 2365606753 Enrollment ID: I20140313002132 |
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