| Millennium Multispecialty Medical Group Inc | |
|
1840 N Hacienda Blvd Ste 14 La Puente CA 91744-1143 | |
| (626) 918-6080 | |
| (626) 918-6880 |
| Full Name | Millennium Multispecialty Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1840 N Hacienda Blvd Ste 14, La Puente, California |
| Authorized Official Name and Position | John Sedgh (OWNER/PRESIDENT) |
| Authorized Official Contact | 6269186080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Millennium Multispecialty Medical Group Inc Po Box 6996 Beverly Hills CA 90212-6996 Ph: (626) 918-6080 | Millennium Multispecialty Medical Group Inc 1840 N Hacienda Blvd Ste 14 La Puente CA 91744-1143 Ph: (626) 918-6080 |
| NPI Number | 1467922195 |
|---|---|
| Provider Enumeration Date | 11/26/2018 |
| Last Update Date | 11/26/2018 |
| Medicare PECOS PAC ID | 7810887809 |
|---|---|
| Medicare Enrollment ID | O20040315001587 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467922195 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | John Sedgh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376760801 PECOS PAC ID: 1153211156 Enrollment ID: I20190423002499 |
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