| Pueblo Medical Center Inc | |
|
8045 Cerritos Ave Stanton CA 90680-2436 | |
| (714) 828-2444 | |
| (714) 816-0529 |
| Full Name | Pueblo Medical Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8045 Cerritos Ave, Stanton, California |
| Authorized Official Name and Position | James Angelo Sharkoff (PRESIDENT) |
| Authorized Official Contact | 7148282444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pueblo Medical Center Inc 8045 Cerritos Ave Stanton CA 90680-2436 Ph: (714) 828-2444 | Pueblo Medical Center Inc 8045 Cerritos Ave Stanton CA 90680-2436 Ph: (714) 828-2444 |
| NPI Number | 1265737043 |
|---|---|
| Provider Enumeration Date | 01/25/2011 |
| Last Update Date | 01/25/2011 |
| Medicare PECOS PAC ID | 0345408837 |
|---|---|
| Medicare Enrollment ID | O20120301000415 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265737043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | James A Sharkoff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891893061 PECOS PAC ID: 3779741269 Enrollment ID: I20120301000462 |
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