| 80/20 Quantum Care | |
|
665 Camino De Los Mares Ste 305 San Clemente CA 92673-2841 | |
| (949) 371-9259 | |
| Not Available |
| Full Name | 80/20 Quantum Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 665 Camino De Los Mares Ste 305, San Clemente, California |
| Authorized Official Name and Position | Maryam Poursartip (INTERNAL MEDICINE) |
| Authorized Official Contact | 9175756669 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 80/20 Quantum Care 258 White Cap Ln Newport Coast CA 92657-1088 Ph: (917) 575-6669 | 80/20 Quantum Care 665 Camino De Los Mares Ste 305 San Clemente CA 92673-2841 Ph: (949) 371-9259 |
| NPI Number | 1407526270 |
|---|---|
| Provider Enumeration Date | 09/14/2021 |
| Last Update Date | 12/21/2021 |
| Medicare PECOS PAC ID | 4284024852 |
|---|---|
| Medicare Enrollment ID | O20220120000558 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407526270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Maryam Poursartip |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225298110 PECOS PAC ID: 9931225406 Enrollment ID: I20220120000638 |
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