| Ppm California LLC | |
|
1470 Civic Ct Ste 310a Concord CA 94520-5230 | |
| (888) 253-6598 | |
| (801) 931-2263 |
| Full Name | Ppm California LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1470 Civic Ct Ste 310a, Concord, California |
| Authorized Official Name and Position | Amber L Tueller (SECRETARY) |
| Authorized Official Contact | 2082072726 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ppm California LLC 1916 N 700 W Ste 110 Layton UT 84041-5754 Ph: (888) 253-6598 | Ppm California LLC 1470 Civic Ct Ste 310a Concord CA 94520-5230 Ph: (888) 253-6598 |
| NPI Number | 1578261749 |
|---|---|
| Provider Enumeration Date | 02/17/2023 |
| Last Update Date | 04/02/2026 |
| Certification Date | 04/02/2026 |
| Medicare PECOS PAC ID | 0749655538 |
|---|---|
| Medicare Enrollment ID | O20230410000567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578261749 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| Provider Name | Tamara Hooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891005112 PECOS PAC ID: 4981044617 Enrollment ID: I20240429002979 |
| Provider Name | Mary Christine Jean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902754070 PECOS PAC ID: 1951877687 Enrollment ID: I20260420001603 |
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