| Dr Mara Renee Archambault, MD | |
|
3833 Emerald Ave, La Verne, CA 91750-2904 | |
| (909) 593-4531 | |
| (909) 392-9598 |
| Full Name | Dr Mara Renee Archambault |
|---|---|
| Gender | Female |
| Speciality | Internal Medicine |
| Experience | 20 Years |
| Location | 3833 Emerald Ave, La Verne, California |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023157021 | NPI | - | NPPES |
| 51659328 | Medicaid | NM | |
| 263282YKR1 | Other | NM | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD2008-0205 (New Mexico) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Healthcare Partners Affiliates Medical Group | 7315842002 | 612 |
| Entity Name | Healthcare Partners Affiliates Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659312593 PECOS PAC ID: 7315842002 Enrollment ID: O20031204001258 |
| Entity Name | Riverside Medical Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720183403 PECOS PAC ID: 2961492327 Enrollment ID: O20040517000880 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mara Renee Archambault, MD Po Box 35380, Las Vegas, NV 89133-5380 Ph: (702) 579-3203 | Dr Mara Renee Archambault, MD 3833 Emerald Ave, La Verne, CA 91750-2904 Ph: (909) 593-4531 |
Dr. Eduardo P Siccion, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 4523 Fruit St, La Verne, CA 91750 Phone: 860-999-9999 | |
Dr. Jeffrey Scott Mason, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 5670 Shemiran St, La Verne, CA 91750 Phone: 909-593-4079 Fax: 951-274-3056 | |
Latha Madhavi Achanta, MD MPH Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2105 Foothill Blvd Ste B262, La Verne, CA 91750 Phone: 909-901-3087 | |
Mr. Sadiq Mandilawi, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1234 Foothill Blvd, La Verne, CA 91750 Phone: 909-596-4879 Fax: 909-596-9199 | |
Mr. James Ito, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 7343 El Nido, La Verne, CA 91750 Phone: 909-596-7245 | |
Dr. Freddie M Ibrahim, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 4222 Bradford St, La Verne, CA 91750 Phone: 909-596-6418 |