| Perpetual Mobile Medical Group Inc | |
|
5015 Eagle Rock Blvd Ste 200 Los Angeles CA 90041-2087 | |
| (323) 455-4868 | |
| (323) 577-7826 |
| Full Name | Perpetual Mobile Medical Group Inc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 5015 Eagle Rock Blvd Ste 200, Los Angeles, California |
| Authorized Official Name and Position | Marlon Camar Salamat (CFO) |
| Authorized Official Contact | 6264976500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Perpetual Mobile Medical Group Inc 1200 E Route 66 Ste 102 Glendora CA 91740-6360 Ph: (323) 455-4868 | Perpetual Mobile Medical Group Inc 5015 Eagle Rock Blvd Ste 200 Los Angeles CA 90041-2087 Ph: (323) 455-4868 |
| NPI Number | 1457084386 |
|---|---|
| Provider Enumeration Date | 07/07/2022 |
| Last Update Date | 08/13/2024 |
| Medicare PECOS PAC ID | 3779951165 |
|---|---|
| Medicare Enrollment ID | O20221115003383 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457084386 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Amable R Aguiluz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1598812596 PECOS PAC ID: 9032000211 Enrollment ID: I20040324001589 |
| Provider Name | Maria Cristina Ortiz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962494641 PECOS PAC ID: 0244226710 Enrollment ID: I20040421000697 |
| Provider Name | Gilbert E Faustina |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558303271 PECOS PAC ID: 7113999798 Enrollment ID: I20040812001043 |
| Provider Name | Abdul Rab Khan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1063400380 PECOS PAC ID: 5496788036 Enrollment ID: I20050914001132 |
| Provider Name | Hermilito Villar |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1710946009 PECOS PAC ID: 4486729720 Enrollment ID: I20120305000235 |
| Provider Name | William Ang Chua |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639199656 PECOS PAC ID: 1658526082 Enrollment ID: I20130308000401 |
| Provider Name | Lilibeth O Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497964688 PECOS PAC ID: 0446497655 Enrollment ID: I20130507000625 |
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