| Sierra Gastroenterology | |
|
44725 10th St W Ste 250 Lancaster CA 93534-3033 | |
| (310) 348-0500 | |
| Not Available |
| Full Name | Sierra Gastroenterology |
|---|---|
| Speciality | Internal Medicine |
| Location | 44725 10th St W, Lancaster, California |
| Authorized Official Name and Position | Steven Garrett (BILLING MANAGER) |
| Authorized Official Contact | 3103480500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sierra Gastroenterology 44725 10th St W Ste 250 Lancaster CA 93534-3033 Ph: () - | Sierra Gastroenterology 44725 10th St W Ste 250 Lancaster CA 93534-3033 Ph: (310) 348-0500 |
| NPI Number | 1083830962 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 02/13/2008 |
| Medicare PECOS PAC ID | 1355393158 |
|---|---|
| Medicare Enrollment ID | O20050218000827 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083830962 | NPI | - | NPPES |
| GR0024400 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Edward T Wong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679559157 PECOS PAC ID: 9436101235 Enrollment ID: I20050225000818 |
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