SUPER CARE MEDICAL GROUP INC NPI 1053652354

NPI Information

SUPER CARE MEDICAL GROUP INC is a general practice in San Gabriel, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee SUPER CARE MEDICAL GROUP INC NPI is 1053652354. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

808 E VALLEY BLVD
SAN GABRIEL, CA
ZIP 91776-607
Phone: (626) 572-3088
Fax: (626) 572-3688

The provider's authorized official is Samuel K Chung .
The authorized official title is Physician Owner and has the following contact phone number (626) 572-3088.

The CLIA number assigned to this NPI record is 05D2063208 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/12/2013 and was last updated on 7/29/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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