Dr Dennis Watanabe, OD | |
4476 Tweedy Blvd, South Gate, CA 90280-6359 | |
(323) 563-9499 | |
(323) 563-9056 |
Full Name | Dr Dennis Watanabe |
---|---|
Gender | Male |
Speciality | Optometrist |
Location | 4476 Tweedy Blvd, South Gate, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851404040 | NPI | - | NPPES |
SD007020 | Medicaid | CA | |
SD0077020 | Medicaid | CA | |
410046776 | Other | CA | MEDICARE RAILROAD |
00OPT7702T0 | Other | CA | BLUE SHIELD |
410046776 | Other | CA | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OPT7702T (California) | Secondary |
152W00000X | Optometrist | 7702T (California) | Primary |
Provider Name | Pioneer Medical Group Inc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1548303589 PECOS PAC ID: 1759317696 Enrollment ID: O20050712001246 |
Mailing Address | Practice Location Address |
---|---|
Dr Dennis Watanabe, OD 75 Remittance Dr, Dept 6008, Chicago, IL 60675-6008 Ph: (562) 282-1419 | Dr Dennis Watanabe, OD 4476 Tweedy Blvd, South Gate, CA 90280-6359 Ph: (323) 563-9499 |
Hanh H Tran Od, Inc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4651 Firestone Blvd, South Gate, CA 90280 Phone: 323-564-2872 Fax: 323-564-0016 | |
Jonathan Kiriboon, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3329 Tweedy Blvd, South Gate, CA 90280 Phone: 323-566-6183 | |
South Gate Optometry Inc Optometrist Medicare: Medicare Enrolled Practice Location: 3329 Tweedy Blvd, South Gate, CA 90280 Phone: 323-566-6183 | |
Dr. Charles Howard Levy, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 8106 Long Beach Blvd, South Gate, CA 90280 Phone: 323-585-5411 Fax: 323-585-6515 | |
Felicia Kang Chen, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 3329 Tweedy Blvd, South Gate, CA 90280 Phone: 323-566-6183 | |
Dr. Katelyn Terese Nguyen, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 10920 Garfield Ave Ste A2, South Gate, CA 90280 Phone: 562-861-9098 Fax: 562-861-9533 | |
Mr. Jack Paul Melmed, OPTOMETRIST Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3329 Tweedy Blvd, South Gate, CA 90280 Phone: 323-566-6183 Fax: 323-566-0319 |