| Fidelis Care Medical Corp | |
|
2520 Gondar Ave Long Beach CA 90815-2216 | |
| (800) 757-9876 | |
| Not Available |
| Full Name | Fidelis Care Medical Corp |
|---|---|
| Speciality | Internal Medicine |
| Location | 2520 Gondar Ave, Long Beach, California |
| Authorized Official Name and Position | Thomas Petit (OWNER) |
| Authorized Official Contact | 8007579876 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fidelis Care Medical Corp 2520 Gondar Ave Long Beach CA 90815-2216 Ph: (800) 757-9876 | Fidelis Care Medical Corp 2520 Gondar Ave Long Beach CA 90815-2216 Ph: (800) 757-9876 |
| NPI Number | 1275324758 |
|---|---|
| Provider Enumeration Date | 05/14/2025 |
| Last Update Date | 05/14/2025 |
| Certification Date | 05/14/2025 |
| Medicare PECOS PAC ID | 5294233466 |
|---|---|
| Medicare Enrollment ID | O20250807004088 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275324758 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Thomas Sean William Petit |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134423387 PECOS PAC ID: 1557544764 Enrollment ID: I20240905003983 |
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