| Prowellness Healthcare Inc. | |
|
8439 White Oak Ave Ste 1038439 Rancho Cucamonga CA 91730-0621 | |
| (818) 532-2222 | |
| (818) 591-7322 |
| Full Name | Prowellness Healthcare Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 8439 White Oak Ave Ste 1038439, Rancho Cucamonga, California |
| Authorized Official Name and Position | Nena Tong Arciaga (PRESIDENT) |
| Authorized Official Contact | 8185322222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prowellness Healthcare Inc. 8439 White Oak Ave Ste 1038439 Rancho Cucamonga CA 91730-0621 Ph: (818) 532-2222 | Prowellness Healthcare Inc. 8439 White Oak Ave Ste 1038439 Rancho Cucamonga CA 91730-0621 Ph: (818) 532-2222 |
| NPI Number | 1053150698 |
|---|---|
| Provider Enumeration Date | 05/22/2024 |
| Last Update Date | 05/22/2024 |
| Medicare PECOS PAC ID | 3870027220 |
|---|---|
| Medicare Enrollment ID | O20241107004143 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053150698 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kamran Kamrava |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1053483800 PECOS PAC ID: 8527257690 Enrollment ID: I20110105001186 |
| Provider Name | Richard Gordon |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1144242645 PECOS PAC ID: 9830096536 Enrollment ID: I20110314000460 |
| Provider Name | Dushyant Viswanathan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285897421 PECOS PAC ID: 8628255692 Enrollment ID: I20140820002310 |
| Provider Name | Aristotle E Santos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932659695 PECOS PAC ID: 7618227018 Enrollment ID: I20190405001412 |
| Provider Name | Mark V Recio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215474390 PECOS PAC ID: 3577804640 Enrollment ID: I20190418001201 |
| Provider Name | Pen Yi Tso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962900233 PECOS PAC ID: 1658791942 Enrollment ID: I20201027001267 |
| Provider Name | Ismael T Gestopa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871266890 PECOS PAC ID: 8224436274 Enrollment ID: I20211006001305 |
| Provider Name | Dorna Rowshanrad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417510504 PECOS PAC ID: 5991179822 Enrollment ID: I20230316000866 |
| Provider Name | Conrado Guadiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942937768 PECOS PAC ID: 2769846948 Enrollment ID: I20230907001538 |
| Provider Name | Hovhannes Ghazaryan |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1851910665 PECOS PAC ID: 1951765965 Enrollment ID: I20230908003550 |
| Provider Name | Andrilyn J Nededog |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952811366 PECOS PAC ID: 4688938434 Enrollment ID: I20250331001961 |
| Provider Name | Lornalyn Grace Tongco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245769561 PECOS PAC ID: 9931536588 Enrollment ID: I20250423003028 |
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