| |
212 Bailey Street Ste 204 Los Angeles CA 90033 | |
(323) 264-5000 | |
(323) 264-5003 |
Full Name | |
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Speciality | Family Medicine |
Location | 212 Bailey Street, Los Angeles, California |
Authorized Official Name and Position | Hector Rafael Castillo (MD, CEO) |
Authorized Official Contact | 3234931788 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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212 Bailey Street Ste 204 Los Angeles CA 90033 Ph: (323) 264-5000 | 212 Bailey Street Ste 204 Los Angeles CA 90033 Ph: (323) 264-5000 |
NPI Number | 1659556058 |
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Provider Enumeration Date | 01/03/2008 |
Last Update Date | 02/04/2016 |
Medicare PECOS PAC ID | 8820176233 |
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Medicare Enrollment ID | O20080425000442 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659556058 | NPI | - | NPPES |
00A761580 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | A76158 (California) | Primary |
Provider Name | Hector Castillo |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1659366136 PECOS PAC ID: 4688645104 Enrollment ID: I20041117001272 |
Provider Name | Arpita Amin Devani |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1962604124 PECOS PAC ID: 3577613173 Enrollment ID: I20090602000337 |
Provider Name | David Cevallos |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1871827766 PECOS PAC ID: 6800052879 Enrollment ID: I20120718000707 |
Joseph I Kang Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3755 Beverly Blvd, Ste 301, Los Angeles, CA 90004 Phone: 323-664-7777 | |
John L Sherman Md Amc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8635 W 3rd St Ste 485w, Los Angeles, CA 90048 Phone: 310-855-8081 Fax: 310-855-0438 | |
Altamed Health Services Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5425 Pomona Blvd, Los Angeles, CA 90022 Phone: 323-832-7527 Fax: 323-832-7599 | |