Montana Affinity Clinic Llc - Medicare Primary Care in Upland, CA

Montana Affinity Clinic Llc is a medicare enrolled primary clinic (Family Medicine) in Upland, California. The current practice location for Montana Affinity Clinic Llc is 820 N Mountain Ave Ste 103, Upland, California. For appointments, you can reach them via phone at (909) 236-5575. The mailing address for Montana Affinity Clinic Llc is 9330 Alderwood Dr, Rancho Cucamonga, California and phone number is (424) 278-8846.

Montana Affinity Clinic Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1205435864. 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) 236-5575.

Contact Information

Montana Affinity Clinic Llc
820 N Mountain Ave Ste 103
Upland
CA 91786-0000
(909) 236-5575
Not Available

Primary Care Clinic Profile

Full NameMontana Affinity Clinic Llc
SpecialityFamily Medicine
Location820 N Mountain Ave Ste 103, Upland, California
Authorized Official Name and PositionJosephine Baisa Montana (OWNER)
Authorized Official Contact9092365575
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Montana Affinity Clinic Llc
9330 Alderwood Dr
Rancho Cucamonga
CA 91730-7966

Ph: (424) 278-8846
Montana Affinity Clinic Llc
820 N Mountain Ave Ste 103
Upland
CA 91786-0000

Ph: (909) 236-5575

NPI Details:

NPI Number1205435864
Provider Enumeration Date10/23/2020
Last Update Date01/06/2021

Medicare PECOS Information:

Medicare PECOS PAC ID7113330457
Medicare Enrollment IDO20210106001439

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Medical Identifiers

Medical identifiers for Montana Affinity Clinic Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1205435864NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily 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. Montana Affinity Clinic Llc acts as a billing entity for following providers:
Provider NameJosephine Baisa Montana
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1417984782
PECOS PAC ID: 6204017767
Enrollment ID: I20110217000084

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