My Family Clinic, Inc. | |
81709 Dr Carreon Blvd Ste C5 Indio CA 92201-5577 | |
(760) 799-4957 | |
(760) 200-2870 |
Full Name | My Family Clinic, Inc. |
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Speciality | Clinic/Center |
Location | 81709 Dr Carreon Blvd Ste C5, Indio, California |
Authorized Official Name and Position | Javier Hernandez (PRESIDENT) |
Authorized Official Contact | 7606259870 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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My Family Clinic, Inc. 43781 Culebra Ln Bermuda Dunes CA 92203-1523 Ph: (760) 799-4957 | My Family Clinic, Inc. 81709 Dr Carreon Blvd Ste C5 Indio CA 92201-5577 Ph: (760) 799-4957 |
NPI Number | 1043603657 |
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Provider Enumeration Date | 03/07/2015 |
Last Update Date | 03/09/2015 |
Medicare PECOS PAC ID | 2163723388 |
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Medicare Enrollment ID | O20151214000439 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043603657 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | A77736 (California) | Primary |
261QP2300X | Clinic/center - Primary Care | RN500867 (California) | Secondary |
Provider Name | Javier Hernandez |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1144318734 PECOS PAC ID: 2668693656 Enrollment ID: I20141015002455 |
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