| Mqm Medical Group Inc | |
|
12826 Victory Blvd Ste E N Hollywood CA 91606-3065 | |
| (818) 583-0055 | |
| (818) 583-0054 |
| Full Name | Mqm Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 12826 Victory Blvd Ste E, N Hollywood, California |
| Authorized Official Name and Position | Mark Bernardi (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8589979105 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mqm Medical Group Inc 5682 Dawn Falls St Las Vegas NV 89148-7650 Ph: (858) 997-9105 | Mqm Medical Group Inc 12826 Victory Blvd Ste E N Hollywood CA 91606-3065 Ph: (818) 583-0055 |
| NPI Number | 1174252951 |
|---|---|
| Provider Enumeration Date | 06/07/2022 |
| Last Update Date | 06/09/2022 |
| Medicare PECOS PAC ID | 0648654343 |
|---|---|
| Medicare Enrollment ID | O20220830001360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174252951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Mark Thomas Bernardi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073900536 PECOS PAC ID: 3476818667 Enrollment ID: I20210210002360 |
| Provider Name | Mahmoud Qasem Moammar |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1952500696 PECOS PAC ID: 9931282332 Enrollment ID: I20210216000893 |
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