| Verdugo Internal Medicine A Medical Group Inc | |
|
1809 Verdugo Blvd Ste 200 Glendale CA 91208 | |
| (818) 790-6225 | |
| (818) 790-6225 |
| Full Name | Verdugo Internal Medicine A Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1809 Verdugo Blvd, Glendale, California |
| Authorized Official Name and Position | Donald W Barber (PRESIDENT) |
| Authorized Official Contact | 8187906225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Verdugo Internal Medicine A Medical Group Inc 1809 Verdugo Blvd Ste 200 Glendale CA 91208 Ph: (818) 790-6225 | Verdugo Internal Medicine A Medical Group Inc 1809 Verdugo Blvd Ste 200 Glendale CA 91208 Ph: (818) 790-6225 |
| NPI Number | 1427149236 |
|---|---|
| Provider Enumeration Date | 09/27/2006 |
| Last Update Date | 08/31/2007 |
| Medicare PECOS PAC ID | 2264583160 |
|---|---|
| Medicare Enrollment ID | O20100208000496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427149236 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (California) | Secondary |
| 207RA0401X | Internal Medicine - Addiction Medicine | (California) | Primary |
| Provider Name | Donald W Barber |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295797439 PECOS PAC ID: 8527119320 Enrollment ID: I20090707000349 |
| Provider Name | James I Wallstrom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710927025 PECOS PAC ID: 3870644677 Enrollment ID: I20100427000272 |
| Provider Name | Victoria A Altree |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609146828 PECOS PAC ID: 3870530942 Enrollment ID: I20140602002347 |
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