| Sun City Medical Group Inc. | |
|
646 W Main St Ste B El Centro CA 92243-7914 | |
| (442) 271-4337 | |
| (833) 906-2293 |
| Full Name | Sun City Medical Group Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 646 W Main St Ste B, El Centro, California |
| Authorized Official Name and Position | John H Guillen (CEO) |
| Authorized Official Contact | 4422714337 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sun City Medical Group Inc. 646 W Main St Ste B El Centro CA 92243-7914 Ph: (442) 271-4337 | Sun City Medical Group Inc. 646 W Main St Ste B El Centro CA 92243-7914 Ph: (442) 271-4337 |
| NPI Number | 1922677319 |
|---|---|
| Provider Enumeration Date | 06/21/2021 |
| Last Update Date | 07/03/2021 |
| Medicare PECOS PAC ID | 1951707678 |
|---|---|
| Medicare Enrollment ID | O20210903002310 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922677319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Ioana Moldovan |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1740201557 PECOS PAC ID: 2163497280 Enrollment ID: I20040831001402 |
| Provider Name | Tu Song Anh Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740217942 PECOS PAC ID: 8224004502 Enrollment ID: I20040908000807 |
| Provider Name | Seleaina A Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871790444 PECOS PAC ID: 5597881052 Enrollment ID: I20100922000469 |
| Provider Name | Justina Tseng |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1346276540 PECOS PAC ID: 7719935519 Enrollment ID: I20160107000433 |
| Provider Name | Cheryl Hodge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548643166 PECOS PAC ID: 4981913191 Enrollment ID: I20170911003169 |
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