Dr Gary D Botimer, MD | |
25455 Barton Rd, Ste 102b, Loma Linda, CA 92354-3128 | |
(909) 558-2808 | |
(909) 558-5599 |
Full Name | Dr Gary D Botimer |
---|---|
Gender | Male |
Speciality | Orthopaedic Surgery |
Location | 25455 Barton Rd, Loma Linda, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124018114 | NPI | - | NPPES |
000010147414 | Other | ID | BLUE SHIELD |
000010005946 | Other | ID | BLUE SHIELD |
B0891 | Other | ID | BLUE CROSS |
200011749 | Other | ID | RAILROAD MEDICARE |
46995 | Other | ID | BLUE CROSS |
002363100 | Medicaid | ID | |
33555 | Other | ID | BLUE SHIELD |
000010005947 | Other | ID | BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207X00000X | Orthopaedic Surgery | M4699 (Idaho) | Primary |
Entity Name | St Lukes Clinic-treasure Valley Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 |
Mailing Address | Practice Location Address |
---|---|
Dr Gary D Botimer, MD 25455 Barton Rd, Ste 102b, Loma Linda, CA 92354-3128 Ph: (909) 558-2808 | Dr Gary D Botimer, MD 25455 Barton Rd, Ste 102b, Loma Linda, CA 92354-3128 Ph: (909) 558-2808 |
Philip Henry Reiswig, M.D. Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 11201 Benton St, Loma Linda, CA 92357 Phone: 909-583-6073 | |
Dr. Corey Brandon Fuller, M.D. Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 25455 Barton Rd Ste 102b, Loma Linda, CA 92354 Phone: 909-558-6444 Fax: 909-558-6118 | |
Parke William Hudson, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 11234 Anderson St, Loma Linda, CA 92354 Phone: 909-558-4000 | |
Allen Nedley, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 11234 Anderson Street, Gme Office Westerly Suite 'c', Loma Linda, CA 92354 Phone: 909-558-6444 | |
Dr. Arthur Thiel, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 25455 Barton Rd, Ste 102b, Loma Linda, CA 92354 Phone: 909-558-2808 Fax: 909-558-5588 | |
Gary Lewis Painter, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 11354 Mountain View Ave Ste A, Loma Linda, CA 92354 Phone: 909-799-7171 Fax: 909-799-5959 |