| Saint Mariam Medical Clinic,inc | |
|
4950 Barranca Pkwy Ste 204 Irvine CA 92604-4687 | |
| (949) 857-1871 | |
| (949) 857-1879 |
| Full Name | Saint Mariam Medical Clinic,inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4950 Barranca Pkwy Ste 204, Irvine, California |
| Authorized Official Name and Position | Hanaa Fam (OWNER) |
| Authorized Official Contact | 9498571871 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Saint Mariam Medical Clinic,inc 4950 Barranca Pkwy Ste 204 Irvine CA 92604-4687 Ph: (949) 857-1871 | Saint Mariam Medical Clinic,inc 4950 Barranca Pkwy Ste 204 Irvine CA 92604-4687 Ph: (949) 857-1871 |
| NPI Number | 1851316707 |
|---|---|
| Provider Enumeration Date | 07/13/2006 |
| Last Update Date | 02/25/2014 |
| Medicare PECOS PAC ID | 0648275719 |
|---|---|
| Medicare Enrollment ID | O20060922000462 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851316707 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A68093 (California) | Primary |
| Provider Name | Hanaa Fam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558311456 PECOS PAC ID: 3678520301 Enrollment ID: I20050405001035 |
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