| V-tach Medical Group Inc. | |
|
301 Victoria St Costa Mesa CA 92627-1995 | |
| (949) 642-2734 | |
| Not Available |
| Full Name | V-tach Medical Group Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 301 Victoria St, Costa Mesa, California |
| Authorized Official Name and Position | Kenneth Rich (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7147475050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| V-tach Medical Group Inc. 506 16th St Huntington Beach CA 92648-4014 Ph: (714) 374-9111 | V-tach Medical Group Inc. 301 Victoria St Costa Mesa CA 92627-1995 Ph: (949) 642-2734 |
| NPI Number | 1578501110 |
|---|---|
| Provider Enumeration Date | 06/04/2006 |
| Last Update Date | 09/06/2023 |
| Medicare PECOS PAC ID | 1759651789 |
|---|---|
| Medicare Enrollment ID | O20170724002133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578501110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | AO50272 (California) | Primary |
| Provider Name | Kenneth Rich |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1801816004 PECOS PAC ID: 0749171999 Enrollment ID: I20040324001386 |
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