| Your Medical Group, Inc | |
|
591 Mccray St Suite 211 Hollister CA 95023-2224 | |
| (831) 531-4213 | |
| Not Available |
| Full Name | Your Medical Group, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 591 Mccray St, Hollister, California |
| Authorized Official Name and Position | Ray Kusumoto (CEO-PRESIDENT) |
| Authorized Official Contact | 8315314213 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Medical Group, Inc 591 Mccray St Suite 211 Hollister CA 95023-2224 Ph: (831) 531-4213 | Your Medical Group, Inc 591 Mccray St Suite 211 Hollister CA 95023-2224 Ph: (831) 531-4213 |
| NPI Number | 1043630106 |
|---|---|
| Provider Enumeration Date | 04/16/2014 |
| Last Update Date | 04/16/2014 |
| Medicare PECOS PAC ID | 5395068563 |
|---|---|
| Medicare Enrollment ID | O20141218001632 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043630106 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Arminda S Tolentino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225131030 PECOS PAC ID: 4789572371 Enrollment ID: I20040330000907 |
| Provider Name | Kenneth Ping Jiang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841279841 PECOS PAC ID: 2466427091 Enrollment ID: I20090805000377 |
| Provider Name | Ariel M Hurtado |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1255659181 PECOS PAC ID: 5092846600 Enrollment ID: I20100625000665 |
| Provider Name | Amelia Y Underwood |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1083065395 PECOS PAC ID: 6103106042 Enrollment ID: I20170117000045 |
| Provider Name | Shiva Mohtashami |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043566623 PECOS PAC ID: 6103130406 Enrollment ID: I20180718001709 |
| Provider Name | Sayuj Paudel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932330883 PECOS PAC ID: 9032375092 Enrollment ID: I20190818000005 |
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