| Mowbray P. Hagan, M.d. Inc. | |
|
500 Corona Mall Corona CA 92879-1420 | |
| (951) 734-6110 | |
| (951) 734-9989 |
| Full Name | Mowbray P. Hagan, M.d. Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 500 Corona Mall, Corona, California |
| Authorized Official Name and Position | Mowbray P. Hagan (PRESIDENT) |
| Authorized Official Contact | 9517346110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mowbray P. Hagan, M.d. Inc. 500 Corona Mall Corona CA 92879-1420 Ph: (951) 734-6110 | Mowbray P. Hagan, M.d. Inc. 500 Corona Mall Corona CA 92879-1420 Ph: (951) 734-6110 |
| NPI Number | 1356353361 |
|---|---|
| Provider Enumeration Date | 08/12/2006 |
| Last Update Date | 09/07/2010 |
| Medicare PECOS PAC ID | 1456316751 |
|---|---|
| Medicare Enrollment ID | O20041129000626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356353361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A29431 (California) | Primary |
| Provider Name | Mowbray P Hagan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235145590 PECOS PAC ID: 1052376365 Enrollment ID: I20050325000640 |
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