| Skilled Provider Network | |
|
110 N Lincoln Ave Ste 100 Corona CA 92882-1853 | |
| (833) 867-8462 | |
| Not Available |
| Full Name | Skilled Provider Network |
|---|---|
| Speciality | General Practice |
| Location | 110 N Lincoln Ave Ste 100, Corona, California |
| Authorized Official Name and Position | Andro Sharobiem (CEO) |
| Authorized Official Contact | 9494121020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Skilled Provider Network 110 N Lincoln Ave Ste 100 Corona CA 92882-1853 | Skilled Provider Network 110 N Lincoln Ave Ste 100 Corona CA 92882-1853 Ph: (833) 867-8462 |
| NPI Number | 1528913597 |
|---|---|
| Provider Enumeration Date | 03/03/2026 |
| Last Update Date | 03/03/2026 |
| Certification Date | 03/03/2026 |
| Medicare PECOS PAC ID | 6901381235 |
|---|---|
| Medicare Enrollment ID | O20260403000878 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528913597 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| Provider Name | Andro N Sharobiem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073711453 PECOS PAC ID: 9234280371 Enrollment ID: I20090630000488 |
| Provider Name | Tammy R Wegrzyn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801123914 PECOS PAC ID: 7214067438 Enrollment ID: I20100615000718 |
| Provider Name | Usama S Khoury |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1538227681 PECOS PAC ID: 6709137060 Enrollment ID: I20180925003810 |
| Provider Name | Heather M Cooksey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952012049 PECOS PAC ID: 4284173865 Enrollment ID: I20240827002808 |
| Provider Name | Jordan M Mercado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871308833 PECOS PAC ID: 0446769210 Enrollment ID: I20250603001836 |
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