| Deen Medical Group Inc | |
|
46 Peninsula Ctr Ste E Rolling Hills Estates CA 90274-3562 | |
| (775) 343-9639 | |
| Not Available |
| Full Name | Deen Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 46 Peninsula Ctr Ste E, Rolling Hills Estates, California |
| Authorized Official Name and Position | Omer Javed Deen (OWNER) |
| Authorized Official Contact | 7753439639 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deen Medical Group Inc 46 Peninsula Ctr Ste E Rolling Hills Estates CA 90274-3562 Ph: (775) 343-9639 | Deen Medical Group Inc 46 Peninsula Ctr Ste E Rolling Hills Estates CA 90274-3562 Ph: (775) 343-9639 |
| NPI Number | 1699165738 |
|---|---|
| Provider Enumeration Date | 01/28/2015 |
| Last Update Date | 01/28/2015 |
| Medicare PECOS PAC ID | 4981919487 |
|---|---|
| Medicare Enrollment ID | O20150812008622 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699165738 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A110888 (California) | Primary |
| Provider Name | Omer J Deen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417123332 PECOS PAC ID: 6709074594 Enrollment ID: I20130503000392 |
| Provider Name | Josephine R Cabugnason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336585819 PECOS PAC ID: 5193965606 Enrollment ID: I20130705000217 |
| Provider Name | Nona P Santos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164868931 PECOS PAC ID: 9638310253 Enrollment ID: I20130724000710 |
| Provider Name | Annalissa L Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740626100 PECOS PAC ID: 5890936363 Enrollment ID: I20130725000385 |
| Provider Name | Michelle De Vela Padre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700487766 PECOS PAC ID: 4688052327 Enrollment ID: I20220608001150 |
| Provider Name | David K Yoo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003529314 PECOS PAC ID: 4587037155 Enrollment ID: I20230301001474 |
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