| Indiana First Medical Group Inc | |
|
4082 Whittier Blvd Ste 103 Los Angeles CA 90023-2559 | |
| (323) 268-5598 | |
| (323) 268-8892 |
| Full Name | Indiana First Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 4082 Whittier Blvd Ste 103, Los Angeles, California |
| Authorized Official Name and Position | Pei Hsin Chao (OWNER) |
| Authorized Official Contact | 3232685598 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indiana First Medical Group Inc Po Box 63202 Los Angeles CA 90063-0202 Ph: (323) 268-5598 | Indiana First Medical Group Inc 4082 Whittier Blvd Ste 103 Los Angeles CA 90023-2559 Ph: (323) 268-5598 |
| NPI Number | 1063591584 |
|---|---|
| Provider Enumeration Date | 11/03/2006 |
| Last Update Date | 06/03/2021 |
| Medicare PECOS PAC ID | 1951346816 |
|---|---|
| Medicare Enrollment ID | O20050930000675 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063591584 | NPI | - | NPPES |
| ZZZ81352Z | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A048560 (California) | Primary |
| Provider Name | Pei H Chao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871636464 PECOS PAC ID: 6305881269 Enrollment ID: I20050930000759 |
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