| Prode P. Pascual, M.d., Inc. | |
|
18331 Gridley Rd Suite C Cerritos CA 90703-5438 | |
| (562) 865-0213 | |
| (562) 865-1050 |
| Full Name | Prode P. Pascual, M.d., Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 18331 Gridley Rd, Cerritos, California |
| Authorized Official Name and Position | Prode Pascual (CEO) |
| Authorized Official Contact | 5628650213 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prode P. Pascual, M.d., Inc. 18331 Gridley Rd Suite C Cerritos CA 90703-5438 Ph: (562) 865-0213 | Prode P. Pascual, M.d., Inc. 18331 Gridley Rd Suite C Cerritos CA 90703-5438 Ph: (562) 865-0213 |
| NPI Number | 1649646209 |
|---|---|
| Provider Enumeration Date | 08/18/2015 |
| Last Update Date | 08/18/2015 |
| Medicare PECOS PAC ID | 8224347232 |
|---|---|
| Medicare Enrollment ID | O20151014000620 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649646209 | NPI | - | NPPES |
| 00A309860 | Medicaid | CA | |
| A30986 | Other | MEDICARE ID-TYPE UNSPECIFIED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A30986 (California) | Primary |
| Provider Name | Prode P Pascual |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558454595 PECOS PAC ID: 5890822720 Enrollment ID: I20100423000367 |
| Provider Name | Allen Kris Navarro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679237598 PECOS PAC ID: 9830570894 Enrollment ID: I20220721002706 |
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