| Executive Medicine, Inc. | |
|
1227 Buena Vista St Suite #f Duarte CA 91010-2486 | |
| (877) 254-4496 | |
| (877) 254-4496 |
| Full Name | Executive Medicine, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1227 Buena Vista St, Duarte, California |
| Authorized Official Name and Position | Ulin Sargeant (PRESIDENT) |
| Authorized Official Contact | 8772544496 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Executive Medicine, Inc. Po Box 2063 Monrovia CA 91017-6063 Ph: (877) 254-4496 | Executive Medicine, Inc. 1227 Buena Vista St Suite #f Duarte CA 91010-2486 Ph: (877) 254-4496 |
| NPI Number | 1407291347 |
|---|---|
| Provider Enumeration Date | 05/06/2013 |
| Last Update Date | 05/01/2024 |
| Medicare PECOS PAC ID | 6800117318 |
|---|---|
| Medicare Enrollment ID | O20150610000175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407291347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A97256 (California) | Primary |
| Provider Name | Ulin Sargeant |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992878151 PECOS PAC ID: 5991886673 Enrollment ID: I20080118000697 |
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