Medrecord | |
22182 Barton Rd Grand Terrace CA 92313-5033 | |
(909) 800-0025 | |
Not Available |
Full Name | Medrecord |
---|---|
Speciality | General Practice |
Location | 22182 Barton Rd, Grand Terrace, California |
Authorized Official Name and Position | Harold Pohang Luke (CHAIRMAN) |
Authorized Official Contact | 9098000025 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Medrecord Po Box 11118 C/o Harold Luke Md San Bernardino CA 92423-1118 Ph: (909) 800-0025 | Medrecord 22182 Barton Rd Grand Terrace CA 92313-5033 Ph: (909) 800-0025 |
NPI Number | 1811266521 |
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Provider Enumeration Date | 12/26/2011 |
Last Update Date | 12/26/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811266521 | NPI | - | NPPES |
00G249341 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | G24934 (California) | Primary |
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