| |
255 N Gilbert Bldg B Hemet CA 92543 | |
(951) 652-4386 | |
(951) 925-4948 |
Full Name | |
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Speciality | Clinic/Center |
Location | 255 N Gilbert, Hemet, California |
Authorized Official Name and Position | Debbie H Kollar (INSURANCE BILLER) |
Authorized Official Contact | 9516524386 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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255 N Gilbert Bldg B Hemet CA 92543 Ph: (951) 652-4386 | 255 N Gilbert Bldg B Hemet CA 92543 Ph: (951) 652-4386 |
NPI Number | 1447341870 |
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Provider Enumeration Date | 09/28/2006 |
Last Update Date | 04/07/2011 |
Medicare PECOS PAC ID | 0042496374 |
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Medicare Enrollment ID | O20110520000202 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447341870 | NPI | - | NPPES |
05C0001230 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 250000447 (California) | Primary |
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