| Vista Medical Group | |
|
2071 Compton Ave Ste 101102 Corona CA 92881-7278 | |
| (951) 549-0900 | |
| (951) 278-8552 |
| Full Name | Vista Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 2071 Compton Ave Ste 101102, Corona, California |
| Authorized Official Name and Position | Naser Wadie Azar (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9515490900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vista Medical Group Po Box 1245 Colton CA 92324-0822 Ph: (951) 549-0900 | Vista Medical Group 2071 Compton Ave Ste 101102 Corona CA 92881-7278 Ph: (951) 549-0900 |
| NPI Number | 1972673846 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 06/16/2023 |
| Medicare PECOS PAC ID | 6002895612 |
|---|---|
| Medicare Enrollment ID | O20050504000915 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972673846 | NPI | - | NPPES |
| Provider Name | Naser W Azar |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1700956331 PECOS PAC ID: 2668452475 Enrollment ID: I20040722000713 |
| Provider Name | Anuradha Sathya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609839141 PECOS PAC ID: 4981741832 Enrollment ID: I20091026000133 |
| Provider Name | Talat A Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992886337 PECOS PAC ID: 1456533959 Enrollment ID: I20110308000023 |
| Provider Name | Cornelia Holmes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679961387 PECOS PAC ID: 4789904814 Enrollment ID: I20150513001512 |
| Provider Name | Elena V Zlochevsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639615776 PECOS PAC ID: 8224462411 Enrollment ID: I20191220001981 |
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