| Quality Medical Clinic, Llc | |
|
3604 Galley Rd Ste 201 Colorado Springs CO 80909-4301 | |
| (719) 638-4548 | |
| Not Available |
| Full Name | Quality Medical Clinic, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3604 Galley Rd Ste 201, Colorado Springs, Colorado |
| Authorized Official Name and Position | Jason Yisu Park (CEO/ PRESIDENT) |
| Authorized Official Contact | 7202401805 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Quality Medical Clinic, Llc 3604 Galley Rd Ste 201 Colorado Springs CO 80909-4301 Ph: (719) 638-4548 | Quality Medical Clinic, Llc 3604 Galley Rd Ste 201 Colorado Springs CO 80909-4301 Ph: (719) 638-4548 |
| NPI Number | 1780288753 |
|---|---|
| Provider Enumeration Date | 11/30/2020 |
| Last Update Date | 02/17/2022 |
| Medicare PECOS PAC ID | 5991117640 |
|---|---|
| Medicare Enrollment ID | O20201222000887 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780288753 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| Provider Name | James T Heiberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336238930 PECOS PAC ID: 9537194618 Enrollment ID: I20050927001450 |
| Provider Name | Jason Yisu Park |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447458369 PECOS PAC ID: 4183724909 Enrollment ID: I20070710000241 |
| Provider Name | Hun Hee Han |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952957987 PECOS PAC ID: 7416386149 Enrollment ID: I20210329001192 |
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