| Med Center Medical Center | |
|
1980 Sequoia Ave Simi Valley CA 93063-3167 | |
| (805) 583-5555 | |
| (805) 583-5554 |
| Full Name | Med Center Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 1980 Sequoia Ave, Simi Valley, California |
| Authorized Official Name and Position | Denice Ruscigno (ADMINISTRATOR) |
| Authorized Official Contact | 8055835555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Med Center Medical Center 1980 Sequoia Ave Simi Valley CA 93063-3167 Ph: (805) 583-5555 | Med Center Medical Center 1980 Sequoia Ave Simi Valley CA 93063-3167 Ph: (805) 583-5555 |
| NPI Number | 1417900788 |
|---|---|
| Provider Enumeration Date | 05/18/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 4981628708 |
|---|---|
| Medicare Enrollment ID | O20060607000149 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417900788 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (California) | Primary |
| Provider Name | Beverley G Kornder |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1477583110 PECOS PAC ID: 5991865198 Enrollment ID: I20081202000529 |
| Provider Name | Munira Husain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184856460 PECOS PAC ID: 9537337357 Enrollment ID: I20110722000144 |
| Provider Name | Tonja A Mundwiller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306950738 PECOS PAC ID: 1456525500 Enrollment ID: I20111129000637 |
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