| Won Jo, Md, Inc | |
|
424 E Vanderbilt Way Ste B San Bernardino CA 92408-3552 | |
| (909) 796-0363 | |
| (909) 255-7292 |
| Full Name | Won Jo, Md, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 424 E Vanderbilt Way Ste B, San Bernardino, California |
| Authorized Official Name and Position | Won-seok Jo (PRESIDENT) |
| Authorized Official Contact | 7143505651 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Won Jo, Md, Inc 424 E Vanderbilt Way Ste B San Bernardino CA 92408-3552 Ph: (909) 796-0363 | Won Jo, Md, Inc 424 E Vanderbilt Way Ste B San Bernardino CA 92408-3552 Ph: (909) 796-0363 |
| NPI Number | 1235354408 |
|---|---|
| Provider Enumeration Date | 04/14/2007 |
| Last Update Date | 10/17/2023 |
| Medicare PECOS PAC ID | 9931261948 |
|---|---|
| Medicare Enrollment ID | O20081230000307 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235354408 | NPI | - | NPPES |
| 1245215144 | Other | CA | NPI (PERSONAL) |
| P00400295 | Other | RAILROAD MEDICARE | |
| 00A912600 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | A91260 (California) | Primary |
| Provider Name | Won Seok Jo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1245215144 PECOS PAC ID: 2961448667 Enrollment ID: I20050705000356 |
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