| San Antonio Regional Medical Group, Inc. | |
|
901 San Bernardino Rd Ste 300 Upland CA 91786-7299 | |
| (909) 920-4801 | |
| Not Available |
| Full Name | San Antonio Regional Medical Group, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 901 San Bernardino Rd Ste 300, Upland, California |
| Authorized Official Name and Position | Sara Khan (PRESIDENT AND TREASURER) |
| Authorized Official Contact | 9099206306 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| San Antonio Regional Medical Group, Inc. 999 San Bernardino Rd Upland CA 91786-4920 Ph: (909) 920-4801 | San Antonio Regional Medical Group, Inc. 901 San Bernardino Rd Ste 300 Upland CA 91786-7299 Ph: (909) 920-4801 |
| NPI Number | 1356913677 |
|---|---|
| Provider Enumeration Date | 07/15/2021 |
| Last Update Date | 07/15/2021 |
| Medicare PECOS PAC ID | 7810388253 |
|---|---|
| Medicare Enrollment ID | O20221004003419 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356913677 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Al Jen Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326295288 PECOS PAC ID: 6901077015 Enrollment ID: I20110921000841 |
| Provider Name | Sara A Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033253414 PECOS PAC ID: 0143481556 Enrollment ID: I20120411000806 |
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