| Perris Valley Medical Group, Inc. | |
|
126 Avocado Ave Suite 207 Perris CA 92571-2605 | |
| (951) 657-0544 | |
| (951) 657-9644 |
| Full Name | Perris Valley Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 126 Avocado Ave, Perris, California |
| Authorized Official Name and Position | George Villanueva (PRESIDENT) |
| Authorized Official Contact | 9516570544 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Perris Valley Medical Group, Inc. 126 Avocado Ave Suite 207 Perris CA 92571-2605 Ph: (951) 657-0544 | Perris Valley Medical Group, Inc. 126 Avocado Ave Suite 207 Perris CA 92571-2605 Ph: (951) 657-0544 |
| NPI Number | 1083851703 |
|---|---|
| Provider Enumeration Date | 01/16/2009 |
| Last Update Date | 02/09/2012 |
| Medicare PECOS PAC ID | 5597817841 |
|---|---|
| Medicare Enrollment ID | O20090716000549 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083851703 | NPI | - | NPPES |
| E90354 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20A6023 (California) | Primary |
| Provider Name | George Villanueva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427132620 PECOS PAC ID: 1951291491 Enrollment ID: I20040317001565 |
County Of Riverside-community Health Agency Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 237 N D St, Perris, CA 92570 Phone: 951-940-6700 Fax: 951-940-6726 | |
My Health Center At Lowe's Perris Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3984 Indiana Ave, Perris, CA 92571 Phone: 951-443-2543 Fax: 951-443-2556 | |
Perris Community Family Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 524 W 4th St Ste B, Perris, CA 92570 Phone: 951-355-0030 Fax: 951-420-5005 | |
Three Angels Medical Professional Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 180 East 4th St, Suite B And C, Perris, CA 92570 Phone: 951-956-2131 Fax: 951-956-2150 | |
Perris Valley Clinica Medica Familiar Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 735 S D St, Perris, CA 92570 Phone: 951-657-3177 Fax: 951-657-4467 | |
Neighborhood Healthcare - Mead Valley Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21705 Martin St, Perris, CA 92570 Phone: 833-867-4642 |