| St. Mary Health Centers- Adelanto | |
|
11965 Cactus Rd Ste Ijk Adelanto CA 92301-4909 | |
| (760) 246-6670 | |
| Not Available |
| Full Name | St. Mary Health Centers- Adelanto |
|---|---|
| Speciality | Clinic/Center |
| Location | 11965 Cactus Rd Ste Ijk, Adelanto, California |
| Authorized Official Name and Position | Timothy Jason Brown (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2088999631 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Mary Health Centers- Adelanto 11965 Cactus Rd Ste Ijk Adelanto CA 92301-4909 Ph: () - | St. Mary Health Centers- Adelanto 11965 Cactus Rd Ste Ijk Adelanto CA 92301-4909 Ph: (760) 246-6670 |
| NPI Number | 1578198727 |
|---|---|
| Provider Enumeration Date | 03/09/2020 |
| Last Update Date | 08/04/2020 |
| Medicare PECOS PAC ID | 4284886789 |
|---|---|
| Medicare Enrollment ID | O20220304002217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578198727 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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