| Premier Medical Group Of California | |
|
901 San Bernardino Rd Suite 101 Upland CA 91786-4912 | |
| (562) 236-3432 | |
| (888) 228-3419 |
| Full Name | Premier Medical Group Of California |
|---|---|
| Speciality | Internal Medicine |
| Location | 901 San Bernardino Rd, Upland, California |
| Authorized Official Name and Position | Ythanh D Nguyen (PARTNER) |
| Authorized Official Contact | 6199930189 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Medical Group Of California 8816 Foothill Blvd Ste 103 Rancho Cucamonga CA 91730-7199 Ph: (562) 236-3432 | Premier Medical Group Of California 901 San Bernardino Rd Suite 101 Upland CA 91786-4912 Ph: (562) 236-3432 |
| NPI Number | 1629523014 |
|---|---|
| Provider Enumeration Date | 08/16/2016 |
| Last Update Date | 06/24/2021 |
| Medicare PECOS PAC ID | 4183909849 |
|---|---|
| Medicare Enrollment ID | O20170320001134 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629523014 | NPI | - | NPPES |
| Provider Name | Ythanh D Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255391181 PECOS PAC ID: 4688603236 Enrollment ID: I20050804000570 |
| Provider Name | Bilal R Rayes |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619095841 PECOS PAC ID: 0648332593 Enrollment ID: I20110401000651 |
| Provider Name | Sara A Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033253414 PECOS PAC ID: 0143481556 Enrollment ID: I20120411000806 |
| Provider Name | Sadia Fatima Moinuddin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912293317 PECOS PAC ID: 1052601820 Enrollment ID: I20160607001201 |
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