| Moqattash Medical Group Inc | |
|
18064 Wika Rd Ste 103 Apple Valley CA 92307-2182 | |
| (760) 906-9362 | |
| Not Available |
| Full Name | Moqattash Medical Group Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 18064 Wika Rd Ste 103, Apple Valley, California |
| Authorized Official Name and Position | Leonardo Moqattash (PRESIDENT) |
| Authorized Official Contact | 9098946737 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moqattash Medical Group Inc Po Box 1927 Victorville CA 92393-1927 Ph: (760) 906-9362 | Moqattash Medical Group Inc 18064 Wika Rd Ste 103 Apple Valley CA 92307-2182 Ph: (760) 906-9362 |
| NPI Number | 1043723562 |
|---|---|
| Provider Enumeration Date | 11/06/2017 |
| Last Update Date | 09/02/2025 |
| Medicare PECOS PAC ID | 2860935608 |
|---|---|
| Medicare Enrollment ID | O20240620002973 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043723562 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Tarek T Moqattash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801029483 PECOS PAC ID: 6002093200 Enrollment ID: I20110615000189 |
| Provider Name | Leonardo S Moqattash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578982823 PECOS PAC ID: 2860763463 Enrollment ID: I20170731003244 |
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