| Live Oak Medical Inc | |
|
20 E Huntington Dr Arcadia CA 91006-3209 | |
| (626) 447-8000 | |
| (626) 447-8002 |
| Full Name | Live Oak Medical Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 20 E Huntington Dr, Arcadia, California |
| Authorized Official Name and Position | Jeffrey Wang (CFO) |
| Authorized Official Contact | 6264478000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Oak Medical Inc 20 E Huntington Dr Arcadia CA 91006-3209 Ph: (626) 447-8000 | Live Oak Medical Inc 20 E Huntington Dr Arcadia CA 91006-3209 Ph: (626) 447-8000 |
| NPI Number | 1750387379 |
|---|---|
| Provider Enumeration Date | 06/28/2005 |
| Last Update Date | 08/23/2013 |
| Medicare PECOS PAC ID | 7113185935 |
|---|---|
| Medicare Enrollment ID | O20120225000066 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750387379 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A50735 (California) | Primary |
| Provider Name | Ida Wu Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164429585 PECOS PAC ID: 8921266743 Enrollment ID: I20120225000080 |
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