| St John Medical Group Inc | |
|
3530 Long Beach Blvd Ste 120 Long Beach CA 90807-3972 | |
| (562) 989-1200 | |
| Not Available |
| Full Name | St John Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3530 Long Beach Blvd Ste 120, Long Beach, California |
| Authorized Official Name and Position | Youssef Awad (MEDICAL OFFICER) |
| Authorized Official Contact | 9095686770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St John Medical Group Inc 3530 Long Beach Blvd Ste 120 Long Beach CA 90807-3972 Ph: (562) 989-1200 | St John Medical Group Inc 3530 Long Beach Blvd Ste 120 Long Beach CA 90807-3972 Ph: (562) 989-1200 |
| NPI Number | 1013188721 |
|---|---|
| Provider Enumeration Date | 03/20/2008 |
| Last Update Date | 06/26/2021 |
| Medicare PECOS PAC ID | 2466511332 |
|---|---|
| Medicare Enrollment ID | O20081106000521 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013188721 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A52194 (California) | Primary |
| Provider Name | Youssef B Awad |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1164528105 PECOS PAC ID: 6305868761 Enrollment ID: I20051228000704 |
| Provider Name | John Awad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366974321 PECOS PAC ID: 0446583785 Enrollment ID: I20200102001975 |
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