| Cardinal Medical Group | |
|
920 Pacific Ave Long Beach CA 90813-4228 | |
| (562) 495-3985 | |
| (562) 495-3452 |
| Full Name | Cardinal Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 920 Pacific Ave, Long Beach, California |
| Authorized Official Name and Position | Harold Cardinal Valery (OWNER) |
| Authorized Official Contact | 5624953985 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cardinal Medical Group 920 Pacific Ave Long Beach CA 90813-4228 Ph: (562) 495-3985 | Cardinal Medical Group 920 Pacific Ave Long Beach CA 90813-4228 Ph: (562) 495-3985 |
| NPI Number | 1104193358 |
|---|---|
| Provider Enumeration Date | 11/16/2011 |
| Last Update Date | 11/28/2011 |
| Medicare PECOS PAC ID | 2163313313 |
|---|---|
| Medicare Enrollment ID | O20040324001411 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104193358 | NPI | - | NPPES |
| 00A350200 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A35020 (California) | Primary |
| Provider Name | Harold C Valery |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1073604716 PECOS PAC ID: 9133010390 Enrollment ID: I20040325001205 |
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