Provider Demographics
NPI:1134349350
Name:MEDPLUS MGT.CLINIC INC
Entity type:Organization
Organization Name:MEDPLUS MGT.CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:RAMOS
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:063-723-0101
Mailing Address - Street 1:279-E RODRIGUEZ AVENUE
Mailing Address - Street 2:SUITE 715 NORTH TOWER CATHEDRAL HTS BLDG ST.LUKES MED
Mailing Address - City:QUEZON CITY
Mailing Address - State:MANILA
Mailing Address - Zip Code:1102
Mailing Address - Country:PH
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:279-E RODRIGUEZ AVENUE
Practice Address - Street 2:SUITE 715 NORTH TOWER CATHEDRAL HTS BLDG ST.LUKES MED
Practice Address - City:QUEZON CITY
Practice Address - State:MANILA
Practice Address - Zip Code:1102
Practice Address - Country:PH
Practice Address - Phone:0632-723-0101
Practice Address - Fax:02-809-8642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0293847162305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization