| Luk Bhava Medical Corporation | |
|
880 S Atlantic Blvd Suite 307 Monterey Park CA 91754-4700 | |
| (626) 300-8424 | |
| Not Available |
| Full Name | Luk Bhava Medical Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 880 S Atlantic Blvd, Monterey Park, California |
| Authorized Official Name and Position | Lukchai Bhavabhutanon (CEO) |
| Authorized Official Contact | 6263008424 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luk Bhava Medical Corporation 880 S Atlantic Blvd Suite 307 Monterey Park CA 91754-4700 Ph: () - | Luk Bhava Medical Corporation 880 S Atlantic Blvd Suite 307 Monterey Park CA 91754-4700 Ph: (626) 300-8424 |
| NPI Number | 1679736268 |
|---|---|
| Provider Enumeration Date | 07/03/2008 |
| Last Update Date | 03/06/2015 |
| Medicare PECOS PAC ID | 6406040153 |
|---|---|
| Medicare Enrollment ID | O20101027000473 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679736268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 20A7134 (California) | Primary |
| Provider Name | Lukchai Bhavabhutanon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922032952 PECOS PAC ID: 7214121961 Enrollment ID: I20101027000527 |
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