| Sac Indio Cvrm Manila | |
|
84110 Manila Ave # B Indio CA 92201-7128 | |
| (909) 382-7100 | |
| Not Available |
| Full Name | Sac Indio Cvrm Manila |
|---|---|
| Speciality | Clinic/Center |
| Location | 84110 Manila Ave # B, Indio, California |
| Authorized Official Name and Position | Tasha Amick (DIRECTOR OF BILLING) |
| Authorized Official Contact | 9093827180 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sac Indio Cvrm Manila 250 S G St San Bernardino CA 92410-3320 Ph: () - | Sac Indio Cvrm Manila 84110 Manila Ave # B Indio CA 92201-7128 Ph: (909) 382-7100 |
| NPI Number | 1386299204 |
|---|---|
| Provider Enumeration Date | 08/07/2019 |
| Last Update Date | 09/01/2022 |
| Medicare PECOS PAC ID | 4385533579 |
|---|---|
| Medicare Enrollment ID | O20210414002761 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386299204 | NPI | - | NPPES |
| CMM70708F | Medicaid | CA | |
| EAP70708F | Other | CA | EAPC |
| ENVOY3000 | Other | CA | ENVOY SITE ID |
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