| Dr Thomas Keith Mogensen, MD | |
|
11955 Pendleton Rd, Yucaipa, CA 92399-4029 | |
| (909) 790-1910 | |
| Not Available |
| Full Name | Dr Thomas Keith Mogensen |
|---|---|
| Gender | Male |
| Speciality | Preventive Medicine - Preventive Medicine/occupational Environmental Medicine |
| Location | 11955 Pendleton Rd, Yucaipa, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578865671 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2083P0500X | Preventive Medicine - Preventive Medicine/occupational Environmental Medicine | G079090 (California) | Primary |
| Entity Name | Desert Valley Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639117864 PECOS PAC ID: 4880595875 Enrollment ID: O20040113000803 |
| Entity Name | American Current Care of California a Medical Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750573622 PECOS PAC ID: 5799854303 Enrollment ID: O20080522000420 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Thomas Keith Mogensen, MD 11955 Pendleton Rd, Yucaipa, CA 92399-4029 Ph: (909) 790-1910 | Dr Thomas Keith Mogensen, MD 11955 Pendleton Rd, Yucaipa, CA 92399-4029 Ph: (909) 790-1910 |
Robert Taber, MD, MPH Preventive Medicine Medicare: Not Enrolled in Medicare Practice Location: 35859 Ivy Ave, Yucaipa, CA 92399 Phone: 714-318-2586 |