| Palmdale Medical Clinic Inc | |
|
540 W Palmdale Blvd Suite B Palmdale CA 93551-4232 | |
| (661) 947-5600 | |
| (661) 947-5900 |
| Full Name | Palmdale Medical Clinic Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 540 W Palmdale Blvd, Palmdale, California |
| Authorized Official Name and Position | Svetlana V Gorelikova (OWNER) |
| Authorized Official Contact | 6619475600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Palmdale Medical Clinic Inc 540 W Palmdale Blvd Suite B Palmdale CA 93551-4232 Ph: (661) 947-5600 | Palmdale Medical Clinic Inc 540 W Palmdale Blvd Suite B Palmdale CA 93551-4232 Ph: (661) 947-5600 |
| NPI Number | 1851849863 |
|---|---|
| Provider Enumeration Date | 09/19/2016 |
| Last Update Date | 09/19/2016 |
| Medicare PECOS PAC ID | 2264703743 |
|---|---|
| Medicare Enrollment ID | O20170801003124 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851849863 | NPI | - | NPPES |
| 102339 | Other | CA | MEDICAL LIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A102339 (California) | Primary |
| Provider Name | Svetlana V Gorelikova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699953604 PECOS PAC ID: 3870644545 Enrollment ID: I20090619000575 |
| Provider Name | Gilbert Pelayo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992031306 PECOS PAC ID: 4981733946 Enrollment ID: I20100601000258 |
| Provider Name | Linh Thi Thuy Dang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326654815 PECOS PAC ID: 7911327473 Enrollment ID: I20201021003298 |
| Provider Name | Fehintolu Gbemisola Olade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538748520 PECOS PAC ID: 7315342276 Enrollment ID: I20210816003776 |
| Provider Name | Denise D Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285306456 PECOS PAC ID: 0648662502 Enrollment ID: I20220126002481 |
| Provider Name | Edris Holland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154929495 PECOS PAC ID: 8123381415 Enrollment ID: I20220923001602 |
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