| Pine Medical Care | |
|
13630 Van Nuys Blvd Ste 107 Pacoima CA 91331-3668 | |
| (323) 455-3595 | |
| (323) 405-0255 |
| Full Name | Pine Medical Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 13630 Van Nuys Blvd Ste 107, Pacoima, California |
| Authorized Official Name and Position | Stephen Pine (OWNER) |
| Authorized Official Contact | 3234553595 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Medical Care 13630 Van Nuys Blvd Ste 107 Pacoima CA 91331-3668 Ph: (323) 455-3595 | Pine Medical Care 13630 Van Nuys Blvd Ste 107 Pacoima CA 91331-3668 Ph: (323) 455-3595 |
| NPI Number | 1942007539 |
|---|---|
| Provider Enumeration Date | 02/28/2025 |
| Last Update Date | 02/28/2025 |
| Medicare PECOS PAC ID | 1850818659 |
|---|---|
| Medicare Enrollment ID | O20250506000778 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942007539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Stephen N Pine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356352108 PECOS PAC ID: 8022055672 Enrollment ID: I20050414000739 |
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