Atul K Khanna, MD | |
2185 W Grant Line Rd, Tracy, CA 95377-7309 | |
(209) 839-3200 | |
Not Available |
Full Name | Atul K Khanna |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 2185 W Grant Line Rd, Tracy, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598843310 | NPI | - | NPPES |
00A667630 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | A66763 (California) | Primary |
Entity Name | Permanente Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
Mailing Address | Practice Location Address |
---|---|
Atul K Khanna, MD 1800 Harrison St Fl 7, Oakland, CA 94612-3466 Ph: (510) 625-6262 | Atul K Khanna, MD 2185 W Grant Line Rd, Tracy, CA 95377-7309 Ph: (209) 839-3200 |
Daisy Yonzon Jones, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 2151 W Grant Line Rd, Tracy, CA 95377 Phone: 209-832-0535 | |
Manuel R De La Cruz, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 518 W Eaton Ave, Tracy, CA 95376 Phone: 209-833-2228 | |
Dr. Monica Lynnette G Stoffer, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4598 S Tracy Blvd Ste 110, Tracy, CA 95377 Phone: 650-497-8000 | |
Natesan Subramanian Rama, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 530 W Eaton Ave, #b, Tracy, CA 95376 Phone: 209-835-9029 Fax: 209-833-9352 | |
Lauren K. Smith, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2185 W Grant Line Rd, Tracy, CA 95377 Phone: 209-839-3200 | |
Daphne Kay Solis, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2185 W Grant Line Rd, Tracy, CA 95377 Phone: 209-839-3200 | |
Roderick L. Estrada, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2185 W Grant Line Rd, Tracy, CA 95377 Phone: 209-839-3200 |