| Pacific Coast Family Medical Group | |
|
1101 N Sepulveda Blvd Ste 102 Manhattan Beach CA 90266-5962 | |
| (310) 545-6627 | |
| (310) 545-0352 |
| Full Name | Pacific Coast Family Medical Group |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 1101 N Sepulveda Blvd Ste 102, Manhattan Beach, California |
| Authorized Official Name and Position | Ronald Ruby J. (PRESIDENT) |
| Authorized Official Contact | 3105456627 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Coast Family Medical Group 1101 N Sepulveda Blvd Ste 102 Manhattan Beach CA 90266-5962 Ph: (310) 545-6627 | Pacific Coast Family Medical Group 1101 N Sepulveda Blvd Ste 102 Manhattan Beach CA 90266-5962 Ph: (310) 545-6627 |
| NPI Number | 1467640409 |
|---|---|
| Provider Enumeration Date | 10/03/2007 |
| Last Update Date | 05/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467640409 | NPI | - | NPPES |
| GR0064100 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | G34101 (California) | Primary |
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