| Super Care Medical Group Inc | |
|
808 E Valley Blvd San Gabriel CA 91776-3607 | |
| (626) 572-3088 | |
| (626) 572-3688 |
| Full Name | Super Care Medical Group Inc |
|---|---|
| Speciality | General Practice |
| Location | 808 E Valley Blvd, San Gabriel, California |
| Authorized Official Name and Position | Samuel K Chung (PHYSICIAN OWNER) |
| Authorized Official Contact | 6265723088 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Super Care Medical Group Inc 808 E Valley Blvd San Gabriel CA 91776-3607 Ph: (626) 572-3088 | Super Care Medical Group Inc 808 E Valley Blvd San Gabriel CA 91776-3607 Ph: (626) 572-3088 |
| NPI Number | 1053652354 |
|---|---|
| Provider Enumeration Date | 03/12/2013 |
| Last Update Date | 07/29/2013 |
| Medicare PECOS PAC ID | 5395976724 |
|---|---|
| Medicare Enrollment ID | O20140327000641 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053652354 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A33894 (California) | Secondary |
| 208600000X | Surgery | A33894 (California) | Secondary |
| 208D00000X | General Practice | A33894 (California) | Primary |
| Provider Name | Samuel K Chung |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992897458 PECOS PAC ID: 7315946316 Enrollment ID: I20061219000616 |
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