Jeffrey O Mcgillicuddy, MD | |
1234 E North St, Suite 103, Manteca, CA 95336-4960 | |
(209) 647-3101 | |
(209) 529-8378 |
Full Name | Jeffrey O Mcgillicuddy |
---|---|
Gender | Male |
Speciality | Orthopaedic Surgery |
Location | 1234 E North St, Manteca, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871698993 | NPI | - | NPPES |
00G845890 | Medicaid | CA | |
500665638 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207X00000X | Orthopaedic Surgery | G84589 (California) | Primary |
Entity Name | Seneca Healthcare District |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326234022 PECOS PAC ID: 8820907140 Enrollment ID: O20031210001061 |
Entity Name | North Pacific Cardiology Medical |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093821837 PECOS PAC ID: 8426113341 Enrollment ID: O20090218000168 |
Entity Name | Orchard Hospital |
---|---|
Entity Type | Part A Provider - Critical Access Hospital |
Entity Identifiers | NPI Number: 1477522019 PECOS PAC ID: 6800709049 Enrollment ID: O20120315000887 |
Entity Name | Synergy Surgicalists, P.c. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1932623782 PECOS PAC ID: 2860768330 Enrollment ID: O20171027002019 |
Mailing Address | Practice Location Address |
---|---|
Jeffrey O Mcgillicuddy, MD 199 Reynolds Road, Chester, CA 96020 Ph: (530) 258-2826 | Jeffrey O Mcgillicuddy, MD 1234 E North St, Suite 103, Manteca, CA 95336-4960 Ph: (209) 647-3101 |
Dr. Bliss Watson Clark Ii, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 1262 E North St, Manteca, CA 95336 Phone: 209-214-7053 Fax: 209-523-0764 | |
Dr. Ronald Ryo Yamada, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 1191 E Yosemite Ave, Ste 203, Manteca, CA 95336 Phone: 916-989-1887 Fax: 916-989-1887 |