| Advanced Regen Medical Inc | |
|
471 Division St Campbell CA 95008-6922 | |
| (408) 871-8222 | |
| Not Available |
| Full Name | Advanced Regen Medical Inc |
|---|---|
| Speciality | Preventive Medicine |
| Location | 471 Division St, Campbell, California |
| Authorized Official Name and Position | Thomas Santucci (OWNER, AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 4088718222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Regen Medical Inc 471 Division St Campbell CA 95008-6922 Ph: (408) 871-8222 | Advanced Regen Medical Inc 471 Division St Campbell CA 95008-6922 Ph: (408) 871-8222 |
| NPI Number | 1922638600 |
|---|---|
| Provider Enumeration Date | 01/22/2020 |
| Last Update Date | 07/20/2020 |
| Medicare PECOS PAC ID | 6305268541 |
|---|---|
| Medicare Enrollment ID | O20200617001332 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922638600 | NPI | - | NPPES |
| Provider Name | Teri Noel Bilhartz |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1144426248 PECOS PAC ID: 9032379631 Enrollment ID: I20120830000148 |
| Provider Name | Lisa M Pavese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891857066 PECOS PAC ID: 3274697842 Enrollment ID: I20131017000514 |
| Provider Name | Katrina Diehl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639841521 PECOS PAC ID: 2264821388 Enrollment ID: I20211111000972 |
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