| Integrated Medical Center Of Corona Inc. | |
|
2250 S Main St Suite 203 Corona CA 92882-2534 | |
| (951) 737-1252 | |
| (951) 737-2820 |
| Full Name | Integrated Medical Center Of Corona Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2250 S Main St, Corona, California |
| Authorized Official Name and Position | Terry Lee Sanderfer (PERSIDENT) |
| Authorized Official Contact | 9517371252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Medical Center Of Corona Inc. 2250 S Main St Suite 203 Corona CA 92882-2534 Ph: (951) 737-1252 | Integrated Medical Center Of Corona Inc. 2250 S Main St Suite 203 Corona CA 92882-2534 Ph: (951) 737-1252 |
| NPI Number | 1023400322 |
|---|---|
| Provider Enumeration Date | 02/23/2015 |
| Last Update Date | 02/23/2015 |
| Medicare PECOS PAC ID | 4981904737 |
|---|---|
| Medicare Enrollment ID | O20151130000961 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023400322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 39736MD (California) | Primary |
| Provider Name | Daniel K Yi |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1669479176 PECOS PAC ID: 0941197891 Enrollment ID: I20040303001350 |
| Provider Name | Christos Bovetas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487740262 PECOS PAC ID: 2062406093 Enrollment ID: I20040413000639 |
| Provider Name | Anthony John Pirritano |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1457343022 PECOS PAC ID: 1951341502 Enrollment ID: I20121023000527 |
| Provider Name | Sarah Marie Alfon |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1265801518 PECOS PAC ID: 1557643327 Enrollment ID: I20170131002571 |
| Provider Name | Holly N Willison |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1942838255 PECOS PAC ID: 6507224631 Enrollment ID: I20230622001754 |
| Provider Name | James M Alfon |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1053997676 PECOS PAC ID: 6103286570 Enrollment ID: I20230717002525 |
| Provider Name | Conrad D Adams |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1407201015 PECOS PAC ID: 3173969771 Enrollment ID: I20240305004584 |
| Provider Name | Evelyn N Sawires |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1285816546 PECOS PAC ID: 4880764695 Enrollment ID: I20240604002570 |
| Provider Name | Lily Chan |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1336795277 PECOS PAC ID: 6507308343 Enrollment ID: I20240607000585 |
| Provider Name | Joanne Nishii |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1457189490 PECOS PAC ID: 2668906298 Enrollment ID: I20241105002556 |
| Provider Name | Maurice J Ellison |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1295580363 PECOS PAC ID: 3274060645 Enrollment ID: I20241224000610 |
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