| San Mateo Medical Clinic, Inc | |
|
4055 Whittier Blvd Los Angeles CA 90023-2536 | |
| (323) 780-4000 | |
| (323) 780-9893 |
| Full Name | San Mateo Medical Clinic, Inc |
|---|---|
| Speciality | General Practice |
| Location | 4055 Whittier Blvd, Los Angeles, California |
| Authorized Official Name and Position | Masad Arbid (OWNER) |
| Authorized Official Contact | 3237804000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| San Mateo Medical Clinic, Inc Po Box 5025 Glendale CA 91221-1025 Ph: (323) 780-4000 | San Mateo Medical Clinic, Inc 4055 Whittier Blvd Los Angeles CA 90023-2536 Ph: (323) 780-4000 |
| NPI Number | 1881795003 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 11/19/2008 |
| Medicare PECOS PAC ID | 2365483922 |
|---|---|
| Medicare Enrollment ID | O20050513000665 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881795003 | NPI | - | NPPES |
| A35390 | Other | CA | PROVIDER LICENSE NUMBER |
| GR0082610 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A35390 (California) | Primary |
| Provider Name | Masad I Arbid |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1043366305 PECOS PAC ID: 3577610534 Enrollment ID: I20090502000047 |
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