| New Genesis Medical Associates, Inc. | |
|
710 N Euclid St Ste 203 Anaheim CA 92801-4122 | |
| (714) 551-9720 | |
| (714) 560-7678 |
| Full Name | New Genesis Medical Associates, Inc. |
|---|---|
| Speciality | Home Health |
| Location | 710 N Euclid St Ste 203, Anaheim, California |
| Authorized Official Name and Position | Mitchell Lew (OWNER) |
| Authorized Official Contact | 7148135129 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Genesis Medical Associates, Inc. 710 N Euclid St # 400 Anaheim CA 92801-4122 Ph: (714) 517-2000 | New Genesis Medical Associates, Inc. 710 N Euclid St Ste 203 Anaheim CA 92801-4122 Ph: (714) 551-9720 |
| NPI Number | 1417208141 |
|---|---|
| Provider Enumeration Date | 09/20/2012 |
| Last Update Date | 01/24/2023 |
| Medicare PECOS PAC ID | 4587815337 |
|---|---|
| Medicare Enrollment ID | O20121105000082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417208141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 251E00000X | Home Health | (* (Not Available)) | Primary |
| Provider Name | Emelia Oduro Jeffrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205210531 PECOS PAC ID: 8527334853 Enrollment ID: I20171031003208 |
| Provider Name | Katerina M Borja |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962983627 PECOS PAC ID: 1254676554 Enrollment ID: I20181214000042 |
| Provider Name | Minami Konishi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982211769 PECOS PAC ID: 3476973892 Enrollment ID: I20221018002151 |
| Provider Name | Yliana M Penalosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053980052 PECOS PAC ID: 1254787609 Enrollment ID: I20240606001685 |
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