La Veta Office | |
1010 W La Veta Ave Suite 750 Orange CA 92868-4304 | |
(714) 361-6600 | |
Not Available |
Full Name | La Veta Office |
---|---|
Speciality | Internal Medicine |
Location | 1010 W La Veta Ave, Orange, California |
Authorized Official Name and Position | Jack Stewart (PRESIDENT - AUTHORIZED OFFICIAL) |
Authorized Official Contact | 7146399401 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
La Veta Office 1010 W La Veta Ave Suite 750 Orange CA 92868-4312 Ph: (714) 361-6600 | La Veta Office 1010 W La Veta Ave Suite 750 Orange CA 92868-4304 Ph: (714) 361-6600 |
NPI Number | 1447410519 |
---|---|
Provider Enumeration Date | 06/12/2008 |
Last Update Date | 06/21/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447410519 | NPI | - | NPPES |
1912919804 | Medicaid | CA | |
CG5665 | Other | CA | RAILROAD MEDICARE GROUP NUMBER |
1912919804 | Other | CA | TYPE 2 NPI |
W1514 | Other | CA | TYPE 2 PTAN |
GR0003350 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
207RP1001X | Internal Medicine - Pulmonary Disease | (* (Not Available)) | Secondary |
News Archive
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