| Pacific Ridge Medical Associates, Inc. | |
|
25401 Cabot Rd Ste 101 Laguna Hills CA 92653-5513 | |
| (949) 768-4850 | |
| (949) 215-9630 |
| Full Name | Pacific Ridge Medical Associates, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 25401 Cabot Rd Ste 101, Laguna Hills, California |
| Authorized Official Name and Position | Alan Y Lo (VICE PRESIDENT) |
| Authorized Official Contact | 9494222589 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Ridge Medical Associates, Inc. 25401 Cabot Rd Ste 101 Laguna Hills CA 92653-5513 Ph: (949) 768-4850 | Pacific Ridge Medical Associates, Inc. 25401 Cabot Rd Ste 101 Laguna Hills CA 92653-5513 Ph: (949) 768-4850 |
| NPI Number | 1114089257 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 12/22/2011 |
| Medicare PECOS PAC ID | 9436052867 |
|---|---|
| Medicare Enrollment ID | O20040131000252 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114089257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 2425685 (California) | Primary |
| Provider Name | Alan Y Lo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982683637 PECOS PAC ID: 9032012463 Enrollment ID: I20040212000935 |
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