| Lotus Medical Services Incorporated | |
|
12047 4th St Yucaipa CA 92399-2735 | |
| (909) 797-5101 | |
| Not Available |
| Full Name | Lotus Medical Services Incorporated |
|---|---|
| Speciality | Family Medicine |
| Location | 12047 4th St, Yucaipa, California |
| Authorized Official Name and Position | Hetana Patel (OWNER) |
| Authorized Official Contact | 4085041051 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lotus Medical Services Incorporated 4131 S Cardinale Privado Unit 2 Ontario CA 91762-7560 Ph: (408) 504-1051 | Lotus Medical Services Incorporated 12047 4th St Yucaipa CA 92399-2735 Ph: (909) 797-5101 |
| NPI Number | 1912631086 |
|---|---|
| Provider Enumeration Date | 07/13/2022 |
| Last Update Date | 07/13/2022 |
| Medicare PECOS PAC ID | 8426433301 |
|---|---|
| Medicare Enrollment ID | O20220913001508 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912631086 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Hetana Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912563362 PECOS PAC ID: 9335524214 Enrollment ID: I20220913001607 |
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