| Smart Choice Medical Group | |
|
4200 Latham St Ste A Riverside CA 92501-1766 | |
| (909) 329-8288 | |
| (562) 309-8477 |
| Full Name | Smart Choice Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 4200 Latham St Ste A, Riverside, California |
| Authorized Official Name and Position | Lashanda Jones (OFFICER) |
| Authorized Official Contact | 2146494946 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smart Choice Medical Group 12926 Riley Ct Rancho Cucamonga CA 91739-8850 Ph: (214) 648-4946 | Smart Choice Medical Group 4200 Latham St Ste A Riverside CA 92501-1766 Ph: (909) 329-8288 |
| NPI Number | 1790567014 |
|---|---|
| Provider Enumeration Date | 10/20/2023 |
| Last Update Date | 10/28/2023 |
| Medicare PECOS PAC ID | 4082063524 |
|---|---|
| Medicare Enrollment ID | O20231211000177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790567014 | NPI | - | NPPES |
| Provider Name | Stephen Eshun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417679465 PECOS PAC ID: 3678948908 Enrollment ID: I20230418002680 |
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