| Modern Concepts Medical Group | |
|
50 Bellefontaine St 404 Pasadena CA 91105-3132 | |
| (323) 728-6070 | |
| (323) 728-2912 |
| Full Name | Modern Concepts Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 50 Bellefontaine St, Pasadena, California |
| Authorized Official Name and Position | Margaret Herrera (PRESIDENT) |
| Authorized Official Contact | 3237286070 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Concepts Medical Group Po Box 640 Montebello CA 90640-0640 Ph: (323) 728-6070 | Modern Concepts Medical Group 50 Bellefontaine St 404 Pasadena CA 91105-3132 Ph: (323) 728-6070 |
| NPI Number | 1194930420 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194930420 | NPI | - | NPPES |
| 05D0936983 | Other | CA | CLIA WAIVER |
| 6495234 | Medicaid | CA | |
| GR0084064 | Medicaid | CA | |
| 1346358827 | Other | CA | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (California) | Primary |
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