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3845 Spring Dr Spring Valley CA 91977-1030 | |
(619) 515-2385 | |
(619) 589-2812 |
Full Name | |
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Speciality | Clinic/Center |
Location | 3845 Spring Dr, Spring Valley, California |
Authorized Official Name and Position | Ricardo Roman (CFO) |
Authorized Official Contact | 6199064603 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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823 Gateway Center Way San Diego CA 92102-4541 Ph: (619) 515-2300 | 3845 Spring Dr Spring Valley CA 91977-1030 Ph: (619) 515-2385 |
NPI Number | 1770789588 |
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Provider Enumeration Date | 06/27/2007 |
Last Update Date | 02/19/2024 |
Medicare PECOS PAC ID | 3476446378 |
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Medicare Enrollment ID | O20170126002649 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770789588 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Emg Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10225 Austin Dr, Ste #103, Spring Valley, CA 91978 Phone: 619-660-6719 Fax: 619-660-5934 | |
Sevak Medical Consultancy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 962 Luther Dr, Spring Valley, CA 91977 Phone: 619-792-7719 | |
Encompass Family Physician Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10225 Austin Dr, Ste # 103, Spring Valley, CA 91978 Phone: 619-660-5719 Fax: 619-660-5934 |