Provider Demographics
NPI:1538710033
Name:RELIABLE CARE MEDICAL GROUP AMC PC
Entity type:Organization
Organization Name:RELIABLE CARE MEDICAL GROUP AMC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARACELY
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-718-1743
Mailing Address - Street 1:1419 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2602
Mailing Address - Country:US
Mailing Address - Phone:619-718-1743
Mailing Address - Fax:619-878-6365
Practice Address - Street 1:1419 E 8TH ST
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2602
Practice Address - Country:US
Practice Address - Phone:619-718-1743
Practice Address - Fax:619-878-6365
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RELIABLE CARE MEDICAL GROUP AMC PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty