| May Medical Management Corporation | |
|
1234 Foothill Blvd La Verne CA 91750-3329 | |
| (909) 596-4879 | |
| (909) 596-9199 |
| Full Name | May Medical Management Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 1234 Foothill Blvd, La Verne, California |
| Authorized Official Name and Position | Sadiq Mandilawi (CO-OWNER) |
| Authorized Official Contact | 9095964879 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| May Medical Management Corporation 1234 Foothill Blvd La Verne CA 91750-3329 Ph: (909) 596-4879 | May Medical Management Corporation 1234 Foothill Blvd La Verne CA 91750-3329 Ph: (909) 596-4879 |
| NPI Number | 1073058103 |
|---|---|
| Provider Enumeration Date | 12/28/2016 |
| Last Update Date | 04/23/2018 |
| Medicare PECOS PAC ID | 2668757055 |
|---|---|
| Medicare Enrollment ID | O20170327002614 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073058103 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
| Provider Name | Sadiq H Mandilawi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1295716736 PECOS PAC ID: 3173670031 Enrollment ID: I20090413000055 |
| Provider Name | Asif Siddiq |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467763078 PECOS PAC ID: 4789832072 Enrollment ID: I20140627001661 |
| Provider Name | Christina Ann Lagazo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679056451 PECOS PAC ID: 6002168226 Enrollment ID: I20181016001976 |
| Provider Name | Soheb Khan |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1376035675 PECOS PAC ID: 9436401510 Enrollment ID: I20211124001877 |
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