| Lomita Family Medical Group Inc | |
|
909 Cardiff St San Diego CA 92114-5019 | |
| (619) 465-3121 | |
| (619) 465-6708 |
| Full Name | Lomita Family Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 909 Cardiff St, San Diego, California |
| Authorized Official Name and Position | Gabriel Gil (PRESIDENT OWNER) |
| Authorized Official Contact | 6194653121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lomita Family Medical Group Inc Po Box #98 Lemon Grove CA 91946-0098 Ph: (619) 465-3121 | Lomita Family Medical Group Inc 909 Cardiff St San Diego CA 92114-5019 Ph: (619) 465-3121 |
| NPI Number | 1336249531 |
|---|---|
| Provider Enumeration Date | 09/25/2006 |
| Last Update Date | 06/04/2009 |
| Medicare PECOS PAC ID | 2163312224 |
|---|---|
| Medicare Enrollment ID | O20040319001304 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336249531 | NPI | - | NPPES |
| 1548361587 | Other | CA | NPI - G. GIL |
| 1639270689 | Other | CA | NPI - SHELDON |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Gabriel Gil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548361587 PECOS PAC ID: 7315837481 Enrollment ID: I20040323002082 |
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