| Sjc Medical Corporation | |
|
3609 Vista Way Suite B Oceanside CA 92056-4522 | |
| (618) 210-4725 | |
| Not Available |
| Full Name | Sjc Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 3609 Vista Way, Oceanside, California |
| Authorized Official Name and Position | Ma. Belen Clark (MD) |
| Authorized Official Contact | 6182104725 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sjc Medical Corporation 23780 Port Royal Ct Tehachapi CA 93561-8585 Ph: () - | Sjc Medical Corporation 3609 Vista Way Suite B Oceanside CA 92056-4522 Ph: (618) 210-4725 |
| NPI Number | 1437466521 |
|---|---|
| Provider Enumeration Date | 09/10/2010 |
| Last Update Date | 09/10/2010 |
| Medicare PECOS PAC ID | 7517156284 |
|---|---|
| Medicare Enrollment ID | O20110111000683 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437466521 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A100202 (California) | Primary |
| Provider Name | Ma Belen S Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194791178 PECOS PAC ID: 2567414576 Enrollment ID: I20080417000182 |
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