| Palliative Partners, Inc | |
|
4310 Orange St Riverside CA 92501-3829 | |
| (951) 781-6335 | |
| (951) 781-6365 |
| Full Name | Palliative Partners, Inc |
|---|---|
| Speciality | General Practice |
| Location | 4310 Orange St, Riverside, California |
| Authorized Official Name and Position | Tarek Z Mahdi (PRESIDENT) |
| Authorized Official Contact | 9517816335 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Palliative Partners, Inc 4310 Orange St Riverside CA 92501-3829 Ph: (951) 781-6335 | Palliative Partners, Inc 4310 Orange St Riverside CA 92501-3829 Ph: (951) 781-6335 |
| NPI Number | 1134304447 |
|---|---|
| Provider Enumeration Date | 01/04/2008 |
| Last Update Date | 10/10/2012 |
| Medicare PECOS PAC ID | 8224100599 |
|---|---|
| Medicare Enrollment ID | O20080701000408 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134304447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A53772 (California) | Primary |
| Provider Name | Tarek Mahdi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932137544 PECOS PAC ID: 1658349170 Enrollment ID: I20090202000594 |
| Provider Name | Ana Ivanova |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104812833 PECOS PAC ID: 6305918673 Enrollment ID: I20100524000443 |
| Provider Name | Cielito B Capistrano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013353549 PECOS PAC ID: 2466687306 Enrollment ID: I20131030000689 |
| Provider Name | Sabrina Yap Garrovillas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811310287 PECOS PAC ID: 2466676507 Enrollment ID: I20140612000170 |
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