| Senior's Choice Medical Group, Inc. | |
|
8990 Sierra Avenue Suite J&k Fontana CA 92335-4772 | |
| (909) 421-4886 | |
| Not Available |
| Full Name | Senior's Choice Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 8990 Sierra Avenue, Fontana, California |
| Authorized Official Name and Position | Guillermo J. Valenzuela (PRESIDENT) |
| Authorized Official Contact | 9095806333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior's Choice Medical Group, Inc. Po Box 1762 Colton CA 92324-0857 Ph: (909) 580-6332 | Senior's Choice Medical Group, Inc. 8990 Sierra Avenue Suite J&k Fontana CA 92335-4772 Ph: (909) 421-4886 |
| NPI Number | 1023506672 |
|---|---|
| Provider Enumeration Date | 04/30/2018 |
| Last Update Date | 05/29/2020 |
| Medicare PECOS PAC ID | 1557600582 |
|---|---|
| Medicare Enrollment ID | O20190308000448 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023506672 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Singh A Boun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801855028 PECOS PAC ID: 9032005574 Enrollment ID: I20040224000840 |
| Provider Name | Afia Ahmed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720624141 PECOS PAC ID: 3375969744 Enrollment ID: I20200814002511 |
| Provider Name | Susan Suen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013425818 PECOS PAC ID: 3274900832 Enrollment ID: I20221110002169 |
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