| Mtblo Medical Group Inc | |
|
540 N Montebello Blvd Ste D Montebello CA 90640 | |
| (323) 728-0080 | |
| (323) 728-0090 |
| Full Name | Mtblo Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 540 N Montebello Blvd Ste D, Montebello, California |
| Authorized Official Name and Position | Michael Gitter (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2133850675 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mtblo Medical Group Inc Po Box 27206 Los Angeles CA 90027-0206 Ph: (213) 385-0675 | Mtblo Medical Group Inc 540 N Montebello Blvd Ste D Montebello CA 90640 Ph: (323) 728-0080 |
| NPI Number | 1316241946 |
|---|---|
| Provider Enumeration Date | 12/22/2010 |
| Last Update Date | 01/20/2021 |
| Medicare PECOS PAC ID | 3779764782 |
|---|---|
| Medicare Enrollment ID | O20110224000179 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316241946 | NPI | - | NPPES |
| 1316241946 | Other | CA | GROUP NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael Gitter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487712865 PECOS PAC ID: 0941246409 Enrollment ID: I20050706000710 |
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