| Eastlake Family Medical Inc. | |
|
2452 Fenton Street Suite 301 Chula Vista CA 91914 | |
| (619) 946-4073 | |
| (619) 946-7243 |
| Full Name | Eastlake Family Medical Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 2452 Fenton Street, Chula Vista, California |
| Authorized Official Name and Position | Maria De Los Angeles Oseguera (PRESIDENT) |
| Authorized Official Contact | 6199464073 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastlake Family Medical Inc. 2452 Fenton Street Suite 301 Chula Vista CA 91914 Ph: (619) 946-4073 | Eastlake Family Medical Inc. 2452 Fenton Street Suite 301 Chula Vista CA 91914 Ph: (619) 946-4073 |
| NPI Number | 1124101985 |
|---|---|
| Provider Enumeration Date | 10/23/2006 |
| Last Update Date | 06/05/2014 |
| Medicare PECOS PAC ID | 2961594387 |
|---|---|
| Medicare Enrollment ID | O20070815000351 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124101985 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20A 6433 (California) | Primary |
| Provider Name | Edward W Schumaker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184616872 PECOS PAC ID: 4587756903 Enrollment ID: I20070815000400 |
| Provider Name | Maria D Oseguera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487627907 PECOS PAC ID: 6305938721 Enrollment ID: I20070815000441 |
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