| Vinod Mishra Md Facg A Professional Corp | |
|
6958 Brockton Ave Ste 201 Riverside CA 92506-3802 | |
| (951) 784-6790 | |
| (951) 784-9919 |
| Full Name | Vinod Mishra Md Facg A Professional Corp |
|---|---|
| Speciality | Internal Medicine |
| Location | 6958 Brockton Ave Ste 201, Riverside, California |
| Authorized Official Name and Position | Vinod Mishra (OWNER) |
| Authorized Official Contact | 9517846790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vinod Mishra Md Facg A Professional Corp 6958 Brockton Ave Ste 201 Riverside CA 92506-3802 Ph: (951) 784-6790 | Vinod Mishra Md Facg A Professional Corp 6958 Brockton Ave Ste 201 Riverside CA 92506-3802 Ph: (951) 784-6790 |
| NPI Number | 1396893863 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4880919232 |
|---|---|
| Medicare Enrollment ID | O20150206001113 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396893863 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | A38396 (California) | Primary |
| Provider Name | Vinod Mishra |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265580724 PECOS PAC ID: 6002916038 Enrollment ID: I20070705000284 |
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