Gradie B Mixon Jr, MD | |
4601 Dale Road, Modesto, CA 95356 | |
(209) 735-5000 | |
Not Available |
Full Name | Gradie B Mixon Jr |
---|---|
Gender | Male |
Speciality | Anesthesiology |
Experience | 44 Years |
Location | 4601 Dale Road, Modesto, California |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164455267 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | G57069 (California) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Permanente Medical Group Inc | 8921910225 | 8376 |
Entity Name | Permanente Medical Group Inc |
---|---|
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 |
---|---|
Gradie B Mixon Jr, MD 604 Cherry Hill Ct, Modesto, CA 95356-9556 Ph: (209) 522-9566 | Gradie B Mixon Jr, MD 4601 Dale Road, Modesto, CA 95356 Ph: (209) 735-5000 |
Vivian L Tan, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 600 Coffee Rd, Modesto, CA 95355 Phone: 209-524-1211 | |
Kenneth Imanaka, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 600 Coffee Rd, Modesto, CA 95355 Phone: 209-524-1211 | |
Brian Paul Richardson, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1441 Florida Ave, Modesto, CA 95350 Phone: 619-933-4258 Fax: 858-777-3387 | |
David Allen Betz, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 600 Coffee Rd, Modesto, CA 95355 Phone: 209-524-1211 | |
Bindi Panjak Patel, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 600 Coffee Rd, Modesto, CA 95355 Phone: 209-521-6097 | |
Vian Younan, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 600 Coffee Rd, Modesto, CA 95355 Phone: 209-521-6097 | |
Ker Yong J Koh, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 600 Coffee Rd, Modesto, CA 95355 Phone: 209-569-7408 |