Sofia R Bulahan, FNP | |
Copperopolis Family Medical Clinic, 3505 Spangler Lane, Suite 400, Copperopolis, CA 95228 | |
(209) 785-7000 | |
Not Available |
Full Name | Sofia R Bulahan |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | Copperopolis Family Medical Clinic, Copperopolis, 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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1760610497 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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363LF0000X | Nurse Practitioner - Family | 17924-N (California) | Primary |
Entity Name | Permanente Medical Group Inc |
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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 |
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Sofia R Bulahan, FNP Mark Twain Medical Center, 768 Mountain Ranch Road, San Andreas, CA 95249 Ph: (209) 754-3521 | Sofia R Bulahan, FNP Copperopolis Family Medical Clinic, 3505 Spangler Lane, Suite 400, Copperopolis, CA 95228 Ph: (209) 785-7000 |
Pennie Khong, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3505 Spangler Ln Ste 400, Copperopolis, CA 95228 Phone: 209-785-7000 | |
Polly Chrysanthemum Dodds, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 430 Sawmill Creek Rd Unit 6, Copperopolis, CA 95228 Phone: 209-785-7000 Fax: 209-785-7025 |