| Prima Primary Medical Association, Inc | |
|
9850 Genesee Ave Suite 355 La Jolla CA 92037-1224 | |
| (858) 202-0011 | |
| (858) 202-0055 |
| Full Name | Prima Primary Medical Association, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9850 Genesee Ave, La Jolla, California |
| Authorized Official Name and Position | Bruce Covner (PRESIDENT) |
| Authorized Official Contact | 8582020011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prima Primary Medical Association, Inc 9850 Genesee Ave Suite 355 La Jolla CA 92037-1224 Ph: (858) 202-0011 | Prima Primary Medical Association, Inc 9850 Genesee Ave Suite 355 La Jolla CA 92037-1224 Ph: (858) 202-0011 |
| NPI Number | 1023002029 |
|---|---|
| Provider Enumeration Date | 09/06/2005 |
| Last Update Date | 05/19/2010 |
| Medicare PECOS PAC ID | 9335030188 |
|---|---|
| Medicare Enrollment ID | O20040322001832 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023002029 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | B1984005592 (California) | Primary |
| Provider Name | Bruce I Covner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720072192 PECOS PAC ID: 1254429087 Enrollment ID: I20071113000236 |
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