| Primehealth 360 Inc | |
|
79440 Corporate Center Dr Ste 111a La Quinta CA 92253-7243 | |
| (760) 444-1422 | |
| Not Available |
| Full Name | Primehealth 360 Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 79440 Corporate Center Dr Ste 111a, La Quinta, California |
| Authorized Official Name and Position | Nina K Maw Maw (OWNER) |
| Authorized Official Contact | 7604441422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primehealth 360 Inc 79440 Corporate Center Dr Ste 111a La Quinta CA 92253-7243 Ph: (760) 444-1422 | Primehealth 360 Inc 79440 Corporate Center Dr Ste 111a La Quinta CA 92253-7243 Ph: (760) 444-1422 |
| NPI Number | 1184269177 |
|---|---|
| Provider Enumeration Date | 11/13/2019 |
| Last Update Date | 09/28/2020 |
| Medicare PECOS PAC ID | 0143656439 |
|---|---|
| Medicare Enrollment ID | O20200205000631 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184269177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Nina Khin Maw Maw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407851777 PECOS PAC ID: 0547257891 Enrollment ID: I20040428000778 |
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