Lucerne Valley H Clinic | |
32770 Old Woman Springs Rd Unit A Lucerne Valley CA 92356 | |
(714) 531-7930 | |
Not Available |
Full Name | Lucerne Valley H Clinic |
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Speciality | Internal Medicine |
Location | 32770 Old Woman Springs Rd, Lucerne Valley, California |
Authorized Official Name and Position | Hoang Tran Nguyen (PRESIDENT) |
Authorized Official Contact | 7144146120 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lucerne Valley H Clinic 10666 Chapman Ave Garden Grove CA 92840-3103 Ph: (714) 531-7930 | Lucerne Valley H Clinic 32770 Old Woman Springs Rd Unit A Lucerne Valley CA 92356 Ph: (714) 531-7930 |
NPI Number | 1073010740 |
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Provider Enumeration Date | 04/10/2018 |
Last Update Date | 10/05/2018 |
Medicare PECOS PAC ID | 8820333941 |
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Medicare Enrollment ID | O20190226002720 |
Identifier | Type | State | Issuer |
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1073010740 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Hoang T Nguyen |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1457329179 PECOS PAC ID: 1355395146 Enrollment ID: I20050304000725 |
Provider Name | Isa Jo |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255682373 PECOS PAC ID: 8426201773 Enrollment ID: I20200514002414 |