Poma Medical Center Inc | |
1017 S Fair Oaks Ave Pasadena CA 91105-2621 | |
(626) 403-9000 | |
Not Available |
Full Name | Poma Medical Center Inc |
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Speciality | Physical Medicine & Rehabilitation |
Location | 1017 S Fair Oaks Ave, Pasadena, California |
Authorized Official Name and Position | Maria Sulindro (PRESIDENT) |
Authorized Official Contact | 6264039000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Poma Medical Center Inc Po Box 80648 San Marino CA 91118-8648 Ph: (626) 403-9000 | Poma Medical Center Inc 1017 S Fair Oaks Ave Pasadena CA 91105-2621 Ph: (626) 403-9000 |
NPI Number | 1396778742 |
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Provider Enumeration Date | 07/09/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 2860420445 |
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Medicare Enrollment ID | O20050803001240 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396778742 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Primary |
Provider Name | Maria Sulindro |
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Provider Type | Practitioner - Physical Medicine And Rehabilitation |
Provider Identifiers | NPI Number: 1598705733 PECOS PAC ID: 7214965896 Enrollment ID: I20050922000391 |
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