| Medrecord | |
|
22182 Barton Rd Grand Terrace CA 92313-5033 | |
| (909) 800-0025 | |
| Not Available |
| Full Name | Medrecord |
|---|---|
| Speciality | General Practice |
| Location | 22182 Barton Rd, Grand Terrace, California |
| Authorized Official Name and Position | Harold Pohang Luke (CHAIRMAN) |
| Authorized Official Contact | 9098000025 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medrecord Po Box 11118 C/o Harold Luke Md San Bernardino CA 92423-1118 Ph: (909) 800-0025 | Medrecord 22182 Barton Rd Grand Terrace CA 92313-5033 Ph: (909) 800-0025 |
| NPI Number | 1811266521 |
|---|---|
| Provider Enumeration Date | 12/26/2011 |
| Last Update Date | 12/26/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811266521 | NPI | - | NPPES |
| 00G249341 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | G24934 (California) | Primary |
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Riverside-san Bernardino County Indian Health, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11980 Mount Vernon Ave, Grand Terrace, CA 92313 Phone: 909-864-1097 |