| Tender Care Community Clinic, Inc | |
|
7862 Firestone Blvd Downey CA 90241 | |
| (562) 869-7007 | |
| (562) 869-2303 |
| Full Name | Tender Care Community Clinic, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7862 Firestone Blvd, Downey, California |
| Authorized Official Name and Position | Tom Santos (CEO) |
| Authorized Official Contact | 5628697007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tender Care Community Clinic, Inc 7862 Firestone Blvd Downey CA 90241 Ph: (562) 869-7007 | Tender Care Community Clinic, Inc 7862 Firestone Blvd Downey CA 90241 Ph: (562) 869-7007 |
| NPI Number | 1134668304 |
|---|---|
| Provider Enumeration Date | 02/21/2017 |
| Last Update Date | 02/21/2017 |
| Medicare PECOS PAC ID | 2264770932 |
|---|---|
| Medicare Enrollment ID | O20190205003511 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134668304 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Virginia A Aguilar |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1104994102 PECOS PAC ID: 8325066996 Enrollment ID: I20051102001178 |
| Provider Name | Adelaida Bustos |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467510040 PECOS PAC ID: 1052492162 Enrollment ID: I20080115000473 |
| Provider Name | Alfonso C Manuel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124563358 PECOS PAC ID: 5294099818 Enrollment ID: I20180508001391 |
| Provider Name | Liezl Santos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316479397 PECOS PAC ID: 7315288321 Enrollment ID: I20190401000431 |
Robert J. Wielenga, Md, A Professional Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10835 New St, Downey, CA 90241 Phone: 562-923-9100 Fax: 562-923-9103 | |
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