| George Mousa MD Prof Inc | |
|
401 E 21st St San Bernardino CA 92404-4845 | |
| (909) 881-3333 | |
| Not Available |
| Full Name | George Mousa MD Prof Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 401 E 21st St, San Bernardino, California |
| Authorized Official Name and Position | George Mousa (OWNER) |
| Authorized Official Contact | 7142617958 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| George Mousa MD Prof Inc 1353 Maywood Ave Upland CA 91786-2543 | George Mousa MD Prof Inc 401 E 21st St San Bernardino CA 92404-4845 Ph: (909) 881-3333 |
| NPI Number | 1679254411 |
|---|---|
| Provider Enumeration Date | 07/25/2023 |
| Last Update Date | 07/25/2023 |
| Certification Date | 07/25/2023 |
| Medicare PECOS PAC ID | 7012371867 |
|---|---|
| Medicare Enrollment ID | O20230912001978 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679254411 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | George Mousa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144711821 PECOS PAC ID: 8022368323 Enrollment ID: I20220909001019 |
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