Med-ped I D Incorporated | |
28078 Baxter Rd Suite 320 Murrieta CA 92563-1402 | |
(951) 679-5811 | |
(951) 679-5844 |
Full Name | Med-ped I D Incorporated |
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Speciality | Internal Medicine |
Location | 28078 Baxter Rd, Murrieta, California |
Authorized Official Name and Position | Chawki Harfouch (EMPLOYEE) |
Authorized Official Contact | 9516795811 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Med-ped I D Incorporated 28078 Baxter Rd Ste 320 Murrieta CA 92563-1404 Ph: (951) 679-5811 | Med-ped I D Incorporated 28078 Baxter Rd Suite 320 Murrieta CA 92563-1402 Ph: (951) 679-5811 |
NPI Number | 1245330364 |
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Provider Enumeration Date | 09/25/2006 |
Last Update Date | 09/13/2023 |
Medicare PECOS PAC ID | 0345292769 |
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Medicare Enrollment ID | O20050214000988 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245330364 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RI0200X | Internal Medicine - Infectious Disease | A60874 (California) | Primary |
261QP1100X | Clinic/center - Podiatric | (* (Not Available)) | Secondary |
Provider Name | Thuan P Le |
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Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1396842704 PECOS PAC ID: 2466346630 Enrollment ID: I20040209001320 |
Provider Name | John P Santoro |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1548271828 PECOS PAC ID: 2365528783 Enrollment ID: I20080326000472 |
Provider Name | Chawki W Harfouch |
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Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1942462783 PECOS PAC ID: 7719044338 Enrollment ID: I20090326000468 |
Provider Name | Timothy Greene |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1578946182 PECOS PAC ID: 1557619640 Enrollment ID: I20191114002486 |
Provider Name | Emily Kim |
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Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1245766088 PECOS PAC ID: 3274998752 Enrollment ID: I20230505001916 |
Provider Name | Amber O'connor |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1023646114 PECOS PAC ID: 1456708429 Enrollment ID: I20231113002463 |
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