Grace Medical Spa - Medicare Primary Care in Riverside, CA

Grace Medical Spa is a medicare enrolled primary clinic (Internal Medicine) in Riverside, California. The current practice location for Grace Medical Spa is 6900 Brockton Ave Ste 200, Riverside, California. For appointments, you can reach them via phone at (909) 664-4634. The mailing address for Grace Medical Spa is 6900 Brockton Ave Ste 200, Riverside, California and phone number is (909) 664-4634.

Grace Medical Spa is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1689357030. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (909) 664-4634.

Contact Information

Grace Medical Spa
6900 Brockton Ave Ste 200
Riverside
CA 92506-3818
(909) 664-4634
Not Available

Primary Care Clinic Profile

Full NameGrace Medical Spa
SpecialityInternal Medicine
Location6900 Brockton Ave Ste 200, Riverside, California
Authorized Official Name and PositionPhillip Alhir (COO)
Authorized Official Contact9096644634
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Grace Medical Spa
6900 Brockton Ave Ste 200
Riverside
CA 92506-3818

Ph: (909) 664-4634
Grace Medical Spa
6900 Brockton Ave Ste 200
Riverside
CA 92506-3818

Ph: (909) 664-4634

NPI Details:

NPI Number1689357030
Provider Enumeration Date08/11/2023
Last Update Date12/08/2023

Medicare PECOS Information:

Medicare PECOS PAC ID0446608087
Medicare Enrollment IDO20231121001188

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Medical Identifiers

Medical identifiers for Grace Medical Spa such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1689357030NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Grace Medical Spa acts as a billing entity for following providers:
Provider NameMelanchton A Mangoba
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1376605717
PECOS PAC ID: 8224113139
Enrollment ID: I20080317000164

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Provider NameMousa Matar
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1992116982
PECOS PAC ID: 2567737026
Enrollment ID: I20210907001912

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Internal Medicine in Riverside, CA

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