Longevita Clinic, A Professional Corporation in Chatsworth, CA

Longevita Clinic, A Professional Corporation is a medicare enrolled primary clinic (Internal Medicine) in Chatsworth, California. The current practice location for Longevita Clinic, A Professional Corporation is 21757 Devonshire St Ste 1, Chatsworth, California. For appointments, you can reach them via phone at (805) 630-7149. The mailing address for Longevita Clinic, A Professional Corporation is 21757 Devonshire St Ste 1, Chatsworth, California and phone number is (818) 678-9875.

Longevita Clinic, A Professional Corporation is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1730774076. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (805) 630-7149.

Contact Information

	Longevita Clinic, A Professional Corporation
	21757 Devonshire St Ste 1 Chatsworth CA 91311-2975
	(805) 630-7149
	(888) 981-8739

Map and Direction

Primary Care Clinic Profile

Full Name	Longevita Clinic, A Professional Corporation
Speciality	Internal Medicine
Location	21757 Devonshire St Ste 1, Chatsworth, California
Authorized Official Name and Position	Richard Park (SECRETARY)
Authorized Official Contact	8053681293
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Longevita Clinic, A Professional Corporation 21757 Devonshire St Ste 1 Chatsworth CA 91311-2975 Ph: (818) 678-9875	Longevita Clinic, A Professional Corporation 21757 Devonshire St Ste 1 Chatsworth CA 91311-2975 Ph: (805) 630-7149

NPI Details:

NPI Number	1730774076
Provider Enumeration Date	03/09/2021
Last Update Date	02/24/2023

Medicare PECOS Information:

Medicare PECOS PAC ID	9133528359
Medicare Enrollment ID	O20210520001175

Medical Identifiers

Medical identifiers for Longevita Clinic, A Professional Corporation such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1730774076	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	(* (Not Available))	Secondary
207R00000X	Internal Medicine	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Longevita Clinic, A Professional Corporation acts as a billing entity for following providers:

Provider Name	Richard Park
Provider Type	Practitioner - Internal Medicine
Provider Identifiers	NPI Number: 1174718134 PECOS PAC ID: 5698964906 Enrollment ID: I20110118000516

Provider Name	Philip Kim
Provider Type	Practitioner - Family Practice
Provider Identifiers	NPI Number: 1356781132 PECOS PAC ID: 5496054330 Enrollment ID: I20200715002512

Reviews and Comments

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Longevita Clinic, A Professional Corporation - Medicare Primary Care in Chatsworth, CA