| Valley Physicians Medical Group, Inc. | |
|
841 W Valley Blvd Suite 104 Alhambra CA 91803-3251 | |
| (626) 282-3113 | |
| (626) 289-9179 |
| Full Name | Valley Physicians Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 841 W Valley Blvd, Alhambra, California |
| Authorized Official Name and Position | Prasert Basil Vassantachart (OWNER) |
| Authorized Official Contact | 6262823113 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Physicians Medical Group, Inc. 841 W Valley Blvd Suite 104 Alhambra CA 91803-3251 Ph: (626) 282-3113 | Valley Physicians Medical Group, Inc. 841 W Valley Blvd Suite 104 Alhambra CA 91803-3251 Ph: (626) 282-3113 |
| NPI Number | 1376538132 |
|---|---|
| Provider Enumeration Date | 09/16/2005 |
| Last Update Date | 09/01/2011 |
| Medicare PECOS PAC ID | 9638349244 |
|---|---|
| Medicare Enrollment ID | O20110908001850 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376538132 | NPI | - | NPPES |
| GR0016470 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | GH4008 (California) | Primary |
| Provider Name | Prasert Basil Vassantachart |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1295720050 PECOS PAC ID: 1254501869 Enrollment ID: I20110908001876 |
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