| Peninsula Primary Care | |
|
5003 Pacific Coast Hwy Torrance CA 90505-5441 | |
| (877) 782-0300 | |
| Not Available |
| Full Name | Peninsula Primary Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 5003 Pacific Coast Hwy, Torrance, California |
| Authorized Official Name and Position | Omer Deen (OWNER) |
| Authorized Official Contact | 3109949903 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peninsula Primary Care 5003 Pacific Coast Hwy Torrance CA 90505-5441 Ph: () - | Peninsula Primary Care 5003 Pacific Coast Hwy Torrance CA 90505-5441 Ph: (877) 782-0300 |
| NPI Number | 1417673328 |
|---|---|
| Provider Enumeration Date | 10/13/2022 |
| Last Update Date | 10/13/2022 |
| Medicare PECOS PAC ID | 3072973007 |
|---|---|
| Medicare Enrollment ID | O20230721001188 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417673328 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Omer J Deen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417123332 PECOS PAC ID: 6709074594 Enrollment ID: I20130503000392 |
| Provider Name | Babar Saeed |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1093989618 PECOS PAC ID: 2365588340 Enrollment ID: I20140111000317 |
| Provider Name | Robin Kucharik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720627789 PECOS PAC ID: 1658754403 Enrollment ID: I20220811003017 |
| Provider Name | Sam Chann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043095078 PECOS PAC ID: 5395195887 Enrollment ID: I20231226000354 |
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