| Southern California Infectious Disease Physicians Medical Group Inc | |
|
18335 E Valley Blvd La Puente CA 91744-5968 | |
| (626) 810-3330 | |
| (626) 964-0440 |
| Full Name | Southern California Infectious Disease Physicians Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 18335 E Valley Blvd, La Puente, California |
| Authorized Official Name and Position | Beena H Shah (PRESIDENT) |
| Authorized Official Contact | 6268103330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern California Infectious Disease Physicians Medical Group Inc 18335 E Valley Blvd La Puente CA 91744-5968 Ph: (626) 810-3330 | Southern California Infectious Disease Physicians Medical Group Inc 18335 E Valley Blvd La Puente CA 91744-5968 Ph: (626) 810-3330 |
| NPI Number | 1114347507 |
|---|---|
| Provider Enumeration Date | 04/24/2014 |
| Last Update Date | 04/24/2014 |
| Medicare PECOS PAC ID | 7719102995 |
|---|---|
| Medicare Enrollment ID | O20140701001828 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114347507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Beena H Shah |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1790795953 PECOS PAC ID: 3577661487 Enrollment ID: I20070530000602 |
| Provider Name | Bharat N Chauhan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1730243759 PECOS PAC ID: 6103018395 Enrollment ID: I20101006000534 |
| Provider Name | Belen Aledia Matias |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1881874691 PECOS PAC ID: 5799790929 Enrollment ID: I20110405000202 |
| Provider Name | Chitra Safaya |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1568624336 PECOS PAC ID: 6901048263 Enrollment ID: I20140520000243 |
| Provider Name | Teresa Kyu Thin Khoo |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1114361813 PECOS PAC ID: 9335403054 Enrollment ID: I20180504002140 |
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