| St Joseph Multi-specialty Clinic Corp | |
|
1557 E Amar Rd Ste F West Covina CA 91792-1678 | |
| (626) 839-9100 | |
| Not Available |
| Full Name | St Joseph Multi-specialty Clinic Corp |
|---|---|
| Speciality | Internal Medicine |
| Location | 1557 E Amar Rd Ste F, West Covina, California |
| Authorized Official Name and Position | Shura A Moreno (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6268399100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Joseph Multi-specialty Clinic Corp 1557 E Amar Rd Ste F West Covina CA 91792-1678 Ph: (626) 839-9100 | St Joseph Multi-specialty Clinic Corp 1557 E Amar Rd Ste F West Covina CA 91792-1678 Ph: (626) 839-9100 |
| NPI Number | 1487286316 |
|---|---|
| Provider Enumeration Date | 02/09/2020 |
| Last Update Date | 02/09/2020 |
| Medicare PECOS PAC ID | 6507295722 |
|---|---|
| Medicare Enrollment ID | O20200408003989 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487286316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Shura A Moreno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174542716 PECOS PAC ID: 2668362450 Enrollment ID: I20040316001333 |
| Provider Name | Rodolfo P Castro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689984320 PECOS PAC ID: 2567644628 Enrollment ID: I20110310000405 |
| Provider Name | Jane T Herico |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699191643 PECOS PAC ID: 0345566378 Enrollment ID: I20150310000218 |
| Provider Name | Joanna Reina M Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316373293 PECOS PAC ID: 9830417732 Enrollment ID: I20150403001027 |
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S Dhand Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1433 West Merced Ave, # 311, West Covina, CA 91790 Phone: 626-960-7759 Fax: 626-337-6373 | |
Wildon Lin Md, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1135 S Sunset Ave, Suite 307, West Covina, CA 91790 Phone: 626-962-1111 Fax: 626-962-1219 |