| Wellfleet Family Medical Inc A Medical Corporation | |
|
600 N Mountain Ave Suite A-100 Upland CA 91786-4359 | |
| (909) 938-2681 | |
| Not Available |
| Full Name | Wellfleet Family Medical Inc A Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 600 N Mountain Ave, Upland, California |
| Authorized Official Name and Position | Annette M Hollenbeck (PRESIDENT) |
| Authorized Official Contact | 9099382681 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellfleet Family Medical Inc A Medical Corporation 600 N Mountain Ave Suite A-100 Upland CA 91786-4359 Ph: (909) 938-2681 | Wellfleet Family Medical Inc A Medical Corporation 600 N Mountain Ave Suite A-100 Upland CA 91786-4359 Ph: (909) 938-2681 |
| NPI Number | 1780081141 |
|---|---|
| Provider Enumeration Date | 12/01/2014 |
| Last Update Date | 12/01/2014 |
| Medicare PECOS PAC ID | 0143547760 |
|---|---|
| Medicare Enrollment ID | O20150319001582 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780081141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Annette M Hollenbeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831366236 PECOS PAC ID: 9032381413 Enrollment ID: I20111006000531 |
John J Kim Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 629 N 13th Ave, Upland, CA 91786 Phone: 909-981-8905 Fax: 909-982-8051 | |
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