| Prisma Care, A Medical Corporation | |
| 
					2648 Main St Suite #a Chula Vista CA 91911-4664  | |
| (619) 575-5000 | |
| (619) 575-5060 | 
| Full Name | Prisma Care, A Medical Corporation | 
|---|---|
| Speciality | Internal Medicine | 
| Location | 2648 Main St, Chula Vista, California | 
| Authorized Official Name and Position | Jose R Lopez (PRESIDENT) | 
| Authorized Official Contact | 6195755000 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Prisma Care, A Medical Corporation 2648 Main St Suite #a Chula Vista CA 91911-4664 Ph: (619) 575-5000  | Prisma Care, A Medical Corporation 2648 Main St Suite #a Chula Vista CA 91911-4664 Ph: (619) 575-5000  | 
| NPI Number | 1093809139 | 
|---|---|
| Provider Enumeration Date | 10/03/2006 | 
| Last Update Date | 07/15/2009 | 
| Medicare PECOS PAC ID | 1658423801 | 
|---|---|
| Medicare Enrollment ID | O20090720000009 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1093809139 | NPI | - | NPPES | 
| 00A433010 | Medicaid | CA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207R00000X | Internal Medicine | A43301 (California) | Primary | 
| Provider Name | Jose R Lopez | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1568667228 PECOS PAC ID: 9436191095 Enrollment ID: I20050524001361  | 
Robert H Moon Md, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1030 White Alder Ave, Chula Vista, CA 91914 Phone: 619-800-6713 Fax: 619-503-9000  | |
Leticia Uwedjojevwe Md Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 340 4th Ave Ste 10, Chula Vista, CA 91910 Phone: 619-934-2215 Fax: 619-934-2340  | |
Family Health Centers Of San Diego Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 248 Landis Ave, Chula Vista, CA 91910 Phone: 619-515-2562 Fax: 619-269-0115  | |
Centro De Salud De La Comunidad De San Ysidro Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1061 Tierra Del Rey, Ste 303, 304, 305, Chula Vista, CA 91910 Phone: 619-662-4100  | |
Family Health Centers Of San Diego, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 264 Landis Ave Ste 100, Chula Vista, CA 91910 Phone: 619-906-5383 Fax: 619-237-1856  | |
Sharna B Shachar M D A Professional Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 525 H St, Chula Vista, CA 91910 Phone: 619-409-9999 Fax: 619-409-9905  | |
Operation Samahan Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 480 4th Ave Ste 401, Chula Vista, CA 91910 Phone: 844-200-2426 Fax: 619-356-2726  |