| Morinda Medical Group | |
|
841 W Morton Ave Porterville CA 93257-3184 | |
| (559) 781-8080 | |
| (559) 781-8960 |
| Full Name | Morinda Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 841 W Morton Ave, Porterville, California |
| Authorized Official Name and Position | Antonio Durazo (OWNER) |
| Authorized Official Contact | 5597818080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Morinda Medical Group 841 W Morton Ave Porterville CA 93257-3184 Ph: (559) 781-8080 | Morinda Medical Group 841 W Morton Ave Porterville CA 93257-3184 Ph: (559) 781-8080 |
| NPI Number | 1194865543 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 02/21/2014 |
| Medicare PECOS PAC ID | 0941226385 |
|---|---|
| Medicare Enrollment ID | O20051014000837 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194865543 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Antonio Durazo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427026145 PECOS PAC ID: 4789650946 Enrollment ID: I20040909000613 |
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