| Renato V. Mungcal, M.d., Inc. | |
|
133 S Vermont Ave Los Angeles CA 90004-5904 | |
| (213) 480-0748 | |
| Not Available |
| Full Name | Renato V. Mungcal, M.d., Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 133 S Vermont Ave, Los Angeles, California |
| Authorized Official Name and Position | Renato Mungcal (PHYSICIAN) |
| Authorized Official Contact | 2134800748 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renato V. Mungcal, M.d., Inc. 133 S Vermont Ave Los Angeles CA 90004-5904 Ph: () - | Renato V. Mungcal, M.d., Inc. 133 S Vermont Ave Los Angeles CA 90004-5904 Ph: (213) 480-0748 |
| NPI Number | 1720550056 |
|---|---|
| Provider Enumeration Date | 12/27/2018 |
| Last Update Date | 07/20/2020 |
| Medicare PECOS PAC ID | 4385983667 |
|---|---|
| Medicare Enrollment ID | O20190304002206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720550056 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Renato V Mungcal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750555413 PECOS PAC ID: 3375799323 Enrollment ID: I20120808000288 |
| Provider Name | Krystle Marie Mantolino Mungcal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518593359 PECOS PAC ID: 1153706395 Enrollment ID: I20220923001674 |
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