| Pavilion Family Physicians Medical Group Inc. | |
|
1140 W La Veta #700 Orange CA 92868 | |
| (714) 547-5404 | |
| (714) 547-0935 |
| Full Name | Pavilion Family Physicians Medical Group Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1140 W La Veta, Orange, California |
| Authorized Official Name and Position | Antonio Ferrey (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7145475404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pavilion Family Physicians Medical Group Inc. 1140 W La Veta #700 Orange CA 92868 Ph: (714) 547-5404 | Pavilion Family Physicians Medical Group Inc. 1140 W La Veta #700 Orange CA 92868 Ph: (714) 547-5404 |
| NPI Number | 1528151511 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 08/23/2023 |
| Medicare PECOS PAC ID | 5294788030 |
|---|---|
| Medicare Enrollment ID | O20050222000255 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528151511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Latika D Arsecularatne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518070382 PECOS PAC ID: 1254350374 Enrollment ID: I20051117000973 |
| Provider Name | Antonio Ferrey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750417549 PECOS PAC ID: 6305973819 Enrollment ID: I20100414000749 |
| Provider Name | Kavita Desai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710013131 PECOS PAC ID: 0042484289 Enrollment ID: I20111128000116 |
| Provider Name | Catherine M Garcia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376679175 PECOS PAC ID: 5597912832 Enrollment ID: I20120822000020 |
| Provider Name | David R Kritz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346376142 PECOS PAC ID: 0244487494 Enrollment ID: I20120823000544 |
| Provider Name | Athena Victoria Trombley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619402872 PECOS PAC ID: 1557774296 Enrollment ID: I20210119001726 |
| Provider Name | Heidy A Sasvin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184183170 PECOS PAC ID: 5597131755 Enrollment ID: I20221013001767 |
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