| Superior Family Medical Group Inc | |
|
1419 Superior Ave 1 Newport Beach CA 92663-2723 | |
| (949) 650-0587 | |
| (949) 631-8155 |
| Full Name | Superior Family Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1419 Superior Ave, Newport Beach, California |
| Authorized Official Name and Position | Rafael Rafael Penunuri (PRESIDENT) |
| Authorized Official Contact | 9496500587 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Superior Family Medical Group Inc 1419 Superior Ave 1 Newport Beach CA 92663-2723 Ph: (949) 650-0587 | Superior Family Medical Group Inc 1419 Superior Ave 1 Newport Beach CA 92663-2723 Ph: (949) 650-0587 |
| NPI Number | 1568645653 |
|---|---|
| Provider Enumeration Date | 12/11/2007 |
| Last Update Date | 04/02/2009 |
| Medicare PECOS PAC ID | 9739230376 |
|---|---|
| Medicare Enrollment ID | O20090622000613 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568645653 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (California) | Primary |
| Provider Name | Rafael A Penunuri |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1831270362 PECOS PAC ID: 1759432396 Enrollment ID: I20090622000595 |
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