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40700 California Oaks Rd Suite 207 Murrieta CA 92562-5789 | |
(951) 677-2252 | |
(951) 677-3838 |
Full Name | |
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Speciality | Clinic/Center |
Location | 40700 California Oaks Rd, Murrieta, California |
Authorized Official Name and Position | Jason A Black (PRESIDENT) |
Authorized Official Contact | 9514914201 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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24680 Jefferson Ave Ste A Murrieta CA 92562-9023 Ph: (951) 677-2252 | 40700 California Oaks Rd Suite 207 Murrieta CA 92562-5789 Ph: (951) 677-2252 |
NPI Number | 1902113186 |
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Provider Enumeration Date | 09/09/2010 |
Last Update Date | 05/31/2019 |
Medicare PECOS PAC ID | 4880873421 |
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Medicare Enrollment ID | O20110127000888 |
Identifier | Type | State | Issuer |
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1902113186 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Jason A Black |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1073587887 PECOS PAC ID: 1951358795 Enrollment ID: I20050405000246 |
Rhoda Estrella-itchon, M.d., Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 25495 Medical Center Dr, Suite 301, Murrieta, CA 92562 Phone: 951-461-1070 | |
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Tuan Ngoc Nguyen Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 28078 Baxter Rd, Suite 320, Murrieta, CA 92563 Phone: 951-246-4546 Fax: 951-672-9036 | |