| Santa Marya Family Medicine Clinic,inc | |
|
3400 W Ball Rd Suite 202 Anaheim CA 92804-3735 | |
| (714) 236-9663 | |
| Not Available |
| Full Name | Santa Marya Family Medicine Clinic,inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3400 W Ball Rd, Anaheim, California |
| Authorized Official Name and Position | Catherine Marks (MD. PRESIDENT) |
| Authorized Official Contact | 7142369663 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Santa Marya Family Medicine Clinic,inc 3400 W Ball Rd Suite 202 Anaheim CA 92804-3735 Ph: (714) 236-9663 | Santa Marya Family Medicine Clinic,inc 3400 W Ball Rd Suite 202 Anaheim CA 92804-3735 Ph: (714) 236-9663 |
| NPI Number | 1245620442 |
|---|---|
| Provider Enumeration Date | 01/27/2015 |
| Last Update Date | 04/03/2015 |
| Medicare PECOS PAC ID | 1951628338 |
|---|---|
| Medicare Enrollment ID | O20150324000435 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245620442 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Assanassios Moussa Faltas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366833899 PECOS PAC ID: 4688991060 Enrollment ID: I20150325001219 |
| Provider Name | Catherine Marks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801214788 PECOS PAC ID: 6406173889 Enrollment ID: I20150325001555 |
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