MEDICARE: MAYFLOWER MEDICAL GROUP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1598232324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAYFLOWER MEDICAL GROUP, INC.

Provider Business Mailing Address
First Line	:	140 N ORANGE AVE STE 100
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91790-2032
Country	:	US
Telephone Number	:	626-800-1200
Fax Number	:	626-962-2471

Provider Business Practice Location Address
First Line	:	11436 GARVEY AVE
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91732-3304
Country	:	US
Telephone Number	:	626-459-5420
Fax Number	:	626-444-4511

Authorized Official
Title or Position	:	SENIOR MANGER
Name	:	ELEONOR RAMIREZ
Credential	:
Telephone Number	:	626-331-2209

Provider Enumeration Date	:	10/30/2018
Last Update Date	:	10/20/2025

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