| Modern Concepts Medical Group, Inc | |
|
1217 W Whittier Blvd Montebello CA 90640-4642 | |
| (323) 728-6070 | |
| (323) 728-2912 |
| Full Name | Modern Concepts Medical Group, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1217 W Whittier Blvd, Montebello, California |
| Authorized Official Name and Position | Margaret Herrera (PRESIDENT) |
| Authorized Official Contact | 3237286070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Concepts Medical Group, Inc Po Box 640 Montebello CA 90640-0640 Ph: (323) 728-6070 | Modern Concepts Medical Group, Inc 1217 W Whittier Blvd Montebello CA 90640-4642 Ph: (323) 728-6070 |
| NPI Number | 1790738243 |
|---|---|
| Provider Enumeration Date | 05/18/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 6901793041 |
|---|---|
| Medicare Enrollment ID | O20040302001418 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790738243 | NPI | - | NPPES |
| GR0084061 | Other | CA | MEDICAL PROV. # ELA OFFIC |
| GR0084062 | Other | CA | MCAL PROV. #- MONTEBELLO |
| GR0084064 | Other | CA | MEDICAL PROV # PASADENA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (California) | Primary |
| Provider Name | Rodolfo A Arevalo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487692372 PECOS PAC ID: 1254229321 Enrollment ID: I20040309001256 |
| Provider Name | Gustavo Calleros |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346358827 PECOS PAC ID: 7618942731 Enrollment ID: I20040831001396 |
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