| Sunrise Gastro Care Pc | |
|
15366 11th St Ste D Victorville CA 92395-3726 | |
| (760) 268-2063 | |
| (760) 268-2063 |
| Full Name | Sunrise Gastro Care Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 15366 11th St Ste D, Victorville, California |
| Authorized Official Name and Position | Henry Chiung-heng Lin (MEDICAL DIRECTOR/ OWNER) |
| Authorized Official Contact | 6166350082 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Gastro Care Pc 12223 Highland Ave. Suite 106 P.o Box 588 Rancho Cucamonga CA 91739 Ph: (760) 268-2063 | Sunrise Gastro Care Pc 15366 11th St Ste D Victorville CA 92395-3726 Ph: (760) 268-2063 |
| NPI Number | 1063042505 |
|---|---|
| Provider Enumeration Date | 01/23/2020 |
| Last Update Date | 08/30/2023 |
| Medicare PECOS PAC ID | 1557799574 |
|---|---|
| Medicare Enrollment ID | O20200325000186 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063042505 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Henry C Lin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1649483033 PECOS PAC ID: 2567516123 Enrollment ID: I20090817000141 |
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