Mvm Medical Corporation | |
3300 E South St Ste 305 Lakewood CA 90805-4549 | |
(562) 817-5602 | |
(562) 817-5605 |
Full Name | Mvm Medical Corporation |
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Speciality | Internal Medicine |
Location | 3300 E South St, Lakewood, California |
Authorized Official Name and Position | Vikram Marfatia (PRESIDENT) |
Authorized Official Contact | 3107562400 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mvm Medical Corporation Po Box 6768 Buena Park CA 90622-6768 Ph: (562) 817-5602 | Mvm Medical Corporation 3300 E South St Ste 305 Lakewood CA 90805-4549 Ph: (562) 817-5602 |
NPI Number | 1730427436 |
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Provider Enumeration Date | 01/30/2013 |
Last Update Date | 10/15/2019 |
Medicare PECOS PAC ID | 7618119132 |
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Medicare Enrollment ID | O20130813000860 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730427436 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Vikram S Marfatia |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1609825579 PECOS PAC ID: 9032102017 Enrollment ID: I20040406000469 |
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Jesse J Licuanan Md A Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3300 E South St, Suite 205, Lakewood, CA 90805 Phone: 562-531-0377 Fax: 562-531-1724 | |
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