Organization
MYPRIME CARE INC
Active
Other names
MY PRIME CARE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN PABLO PESQUEIRA GONZALEZ MD (PRESIDENT/OWNER)
(626) 550-4545
Entity
Organization
Contact information
Practice address
543 S CALIFORNIA AVE, WEST COVINA, CA 91790-3640
(626) 550-4545
Mailing address
543 S CALIFORNIA AVE, WEST COVINA, CA 91790-3640
(626) 550-4545
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538738265
PERSONAL NPI
—
Enumeration date
12/10/2024
Last updated
01/30/2025
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