| Medical Wellness Group, Inc. | |
|
41749 Brownstown Dr Bermuda Dunes CA 92203-1042 | |
| (760) 636-9893 | |
| Not Available |
| Full Name | Medical Wellness Group, Inc. |
|---|---|
| Speciality | General Practice |
| Location | 41749 Brownstown Dr, Bermuda Dunes, California |
| Authorized Official Name and Position | Lawrence E Le Roy (CEO) |
| Authorized Official Contact | 7603608700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Wellness Group, Inc. 41749 Brownstown Dr Bermuda Dunes CA 92203-1042 Ph: (760) 636-9893 | Medical Wellness Group, Inc. 41749 Brownstown Dr Bermuda Dunes CA 92203-1042 Ph: (760) 636-9893 |
| NPI Number | 1063959187 |
|---|---|
| Provider Enumeration Date | 01/26/2017 |
| Last Update Date | 08/17/2022 |
| Medicare PECOS PAC ID | 7810272416 |
|---|---|
| Medicare Enrollment ID | O20170329001423 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063959187 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 3978244 (California) | Primary |
| Provider Name | Scott E Dlugos |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790748234 PECOS PAC ID: 6002729837 Enrollment ID: I20031107000605 |
| Provider Name | Tiffany M Hood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730643362 PECOS PAC ID: 1557695624 Enrollment ID: I20190624001162 |
| Provider Name | Laura G Padron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518318047 PECOS PAC ID: 1052606548 Enrollment ID: I20210225001046 |
| Provider Name | Alicia Berenice Rios |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033885991 PECOS PAC ID: 7315344868 Enrollment ID: I20210925000109 |
| Provider Name | Carlos Colon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790456465 PECOS PAC ID: 9638560626 Enrollment ID: I20211230000852 |
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