| San Rafael Community Medical Clinic | |
|
1126 W Mission Blvd Pomona CA 91766-1342 | |
| (909) 865-2538 | |
| (909) 865-2508 |
| Full Name | San Rafael Community Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1126 W Mission Blvd, Pomona, California |
| Authorized Official Name and Position | Rafael Carcamo (PRESIDENT) |
| Authorized Official Contact | 9098652538 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Rafael Community Medical Clinic 1126 W Mission Blvd Pomona CA 91766-1342 Ph: (909) 865-2538 | San Rafael Community Medical Clinic 1126 W Mission Blvd Pomona CA 91766-1342 Ph: (909) 865-2538 |
| NPI Number | 1104043835 |
|---|---|
| Provider Enumeration Date | 04/20/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104043835 | NPI | - | NPPES |
| GR0090561 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 00A666750 (California) | Primary |
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