Ekaterina Nikolaevna Petrova, MD | |
1510 Florida Ave, Modesto, CA 95350-4437 | |
(209) 549-7090 | |
(209) 549-7099 |
Full Name | Ekaterina Nikolaevna Petrova |
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Gender | Female |
Speciality | Pediatrics |
Location | 1510 Florida Ave, Modesto, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265750129 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 042-0011975 (Vermont) | Secondary |
208000000X | Pediatrics | A127080 (California) | Primary |
Entity Name | Golden Valley Health Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356445753 PECOS PAC ID: 4183527187 Enrollment ID: O20040128000641 |
Mailing Address | Practice Location Address |
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Ekaterina Nikolaevna Petrova, MD 737 W Childs Ave, Merced, CA 95341-6805 Ph: (209) 384-6493 | Ekaterina Nikolaevna Petrova, MD 1510 Florida Ave, Modesto, CA 95350-4437 Ph: (209) 549-7090 |
Charnjeet K Randhawa, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4601 Dale Rd, Modesto, CA 95356 Phone: 209-735-5000 Fax: 559-459-4569 | |
Mohamed Ashkar, Pediatrics Medicare: Medicare Enrolled Practice Location: 1510 Florida Ave, Modesto, CA 95350 Phone: 209-722-4842 | |
Lee T Donohue, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 600 Coffee Rd, Modesto, CA 95355 Phone: 209-569-7408 | |
Angela I Lin, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1144 Coffee Rd, Modesto, CA 95355 Phone: 209-550-4744 | |
Miss Donna Silva, NP Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4120 Prescott Rd, Modesto, CA 95356 Phone: 209-544-7300 Fax: 209-544-7323 | |
Dr. Mary Jessie Sumithra, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 4125 Bangs Ave, Modesto, CA 95356 Phone: 209-557-1630 | |
Dena Ann Lenser, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3109 Coffee Rd, Ste A, Modesto, CA 95355 Phone: 209-522-0001 Fax: 209-549-7077 |