| Lucerne Valley Healthcare, Inc. | |
|
32770 Old Woman Springs Rd Unit A Lucerne Valley CA 92356 | |
| (714) 531-7930 | |
| Not Available |
| Full Name | Lucerne Valley Healthcare, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 32770 Old Woman Springs Rd, Lucerne Valley, California |
| Authorized Official Name and Position | Hoang Tran Nguyen (PRESIDENT) |
| Authorized Official Contact | 7144146120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lucerne Valley Healthcare, Inc. 10666 Chapman Ave Garden Grove CA 92840-3103 Ph: (714) 531-7930 | Lucerne Valley Healthcare, Inc. 32770 Old Woman Springs Rd Unit A Lucerne Valley CA 92356 Ph: (714) 531-7930 |
| NPI Number | 1073010740 |
|---|---|
| Provider Enumeration Date | 04/10/2018 |
| Last Update Date | 10/05/2018 |
| Medicare PECOS PAC ID | 8820333941 |
|---|---|
| Medicare Enrollment ID | O20190226002720 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073010740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Hoang T Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457329179 PECOS PAC ID: 1355395146 Enrollment ID: I20050304000725 |
| Provider Name | Isa Jo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255682373 PECOS PAC ID: 8426201773 Enrollment ID: I20200514002414 |