Mykenzie Lauren Mattheis, DO | |
999 S Fairmont Ave Ste 200, Lodi, CA 95240-5141 | |
(209) 334-3333 | |
Not Available |
Full Name | Mykenzie Lauren Mattheis |
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Gender | Female |
Speciality | Obstetrics & Gynecology |
Location | 999 S Fairmont Ave Ste 200, Lodi, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1992266464 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207V00000X | Obstetrics & Gynecology | 20A21012 (California) | Secondary |
207V00000X | Obstetrics & Gynecology | 74979-21 (Wisconsin) | Primary |
Entity Name | Sutter Valley Medical Foundation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1669846986 PECOS PAC ID: 9830094515 Enrollment ID: O20090311000335 |
Mailing Address | Practice Location Address |
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Mykenzie Lauren Mattheis, DO Po Box 255228, Sacramento, CA 95865-5228 Ph: () - | Mykenzie Lauren Mattheis, DO 999 S Fairmont Ave Ste 200, Lodi, CA 95240-5141 Ph: (209) 334-3333 |
Manjeet K Bryson, NP RN Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 999 South Fairmont Ste 225, P Gill Obstetrics & Gynecology Medical Grp Inc, Lodi, CA 95240 Phone: 209-334-3343 Fax: 209-334-1430 | |
Philip A Dodd, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 999 S Fairmont Ave, Suite 200, Lodi, CA 95240 Phone: 209-334-3333 Fax: 209-369-2641 | |
Robert Glenn Howen, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 999 S Fairmont Ave, Ste 200, Lodi, CA 95240 Phone: 209-334-3333 | |
Leslie D Sackschewsky, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 999 S Fairmont Ave, Suite 200, Lodi, CA 95240 Phone: 209-334-3333 Fax: 209-369-2641 | |
Carol Lynn Nakashima, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 999 S Fairmont Ave, Ste 200, Lodi, CA 95240 Phone: 209-334-3333 Fax: 209-369-2641 | |
Dr. Kimberley E Fillmore, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 999 S Fairmont Ave, Ste. 230, Lodi, CA 95240 Phone: 209-334-4924 Fax: 209-334-0127 | |
Dr. Peter Kyung-sun Yang, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1103 Rivergate Dr, Lodi, CA 95240 Phone: 209-334-6593 |