| Smartcare Medical Group, Inc. | |
|
255 W Herndon Ave Ste 103 Clovis CA 93612-0381 | |
| (559) 570-0070 | |
| (559) 570-0059 |
| Full Name | Smartcare Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 255 W Herndon Ave Ste 103, Clovis, California |
| Authorized Official Name and Position | Margarita Paulina Garcia (NETWORK ADMINISTRATOR) |
| Authorized Official Contact | 5598789060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smartcare Medical Group, Inc. 255 W Herndon Ave Ste 103 Clovis CA 93612-0381 Ph: (559) 570-0070 | Smartcare Medical Group, Inc. 255 W Herndon Ave Ste 103 Clovis CA 93612-0381 Ph: (559) 570-0070 |
| NPI Number | 1912588914 |
|---|---|
| Provider Enumeration Date | 04/20/2021 |
| Last Update Date | 06/08/2021 |
| Medicare PECOS PAC ID | 7012318785 |
|---|---|
| Medicare Enrollment ID | O20210701002102 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912588914 | NPI | - | NPPES |
| 4691222 | Other | CA | ARTICLES OF CORPORATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Cynthia L Baer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770564270 PECOS PAC ID: 3779579602 Enrollment ID: I20040423001411 |
| Provider Name | Lee R Copeland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619958501 PECOS PAC ID: 0749188464 Enrollment ID: I20080630000116 |
| Provider Name | Gregory L Copeland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154528123 PECOS PAC ID: 1456490945 Enrollment ID: I20091121000138 |
| Provider Name | Khampha Thephavong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194901173 PECOS PAC ID: 7416085766 Enrollment ID: I20100507000304 |
| Provider Name | Juyong Bong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225491400 PECOS PAC ID: 3274879804 Enrollment ID: I20220317002843 |
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