| Moreno Valley Medical Group, Inc | |
|
24490 Sunnymead Blvd Moreno Valley CA 92553-7734 | |
| (951) 242-9595 | |
| Not Available |
| Full Name | Moreno Valley Medical Group, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 24490 Sunnymead Blvd, Moreno Valley, California |
| Authorized Official Name and Position | Jeffrey P Richards (OFFICE MANAGER) |
| Authorized Official Contact | 9512429595 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moreno Valley Medical Group, Inc 24490 Sunnymead Blvd Ste 117 Moreno Valley CA 92553-7764 Ph: (951) 242-9595 | Moreno Valley Medical Group, Inc 24490 Sunnymead Blvd Moreno Valley CA 92553-7734 Ph: (951) 242-9595 |
| NPI Number | 1740815166 |
|---|---|
| Provider Enumeration Date | 03/05/2020 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740815166 | NPI | - | NPPES |
| 00A703100 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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Joel A Pengson, Md, A Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 23180 Hemlock Ave, Moreno Valley, CA 92557 Phone: 951-243-6460 | |
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