| The Endocrine Medical Group | |
|
1140 W La Veta Suite 420 Orange CA 92868 | |
| (714) 285-1904 | |
| (714) 571-5979 |
| Full Name | The Endocrine Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 1140 W La Veta, Orange, California |
| Authorized Official Name and Position | Samuel O Mayeda (PHYSICIAN OWNER) |
| Authorized Official Contact | 7142851904 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Endocrine Medical Group 1140 W La Veta Ste 420 Orange CA 92868 Ph: (714) 285-1904 | The Endocrine Medical Group 1140 W La Veta Suite 420 Orange CA 92868 Ph: (714) 285-1904 |
| NPI Number | 1770666828 |
|---|---|
| Provider Enumeration Date | 10/23/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8921081084 |
|---|---|
| Medicare Enrollment ID | O20040609001495 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770666828 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Samuel O Mayeda |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1487716544 PECOS PAC ID: 7113186479 Enrollment ID: I20120307000102 |
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