| Av Corp Inc | |
|
4568 Feather River Dr Ste D Stockton CA 95219-6508 | |
| (734) 776-7889 | |
| Not Available |
| Full Name | Av Corp Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 4568 Feather River Dr Ste D, Stockton, California |
| Authorized Official Name and Position | Atul Verma (MEDICAL DIRCETOR) |
| Authorized Official Contact | 7347767889 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Av Corp Inc 9837 Kapalua Ln Elk Grove CA 95624-5003 Ph: (734) 776-7889 | Av Corp Inc 4568 Feather River Dr Ste D Stockton CA 95219-6508 Ph: (734) 776-7889 |
| NPI Number | 1376223024 |
|---|---|
| Provider Enumeration Date | 07/18/2023 |
| Last Update Date | 07/21/2023 |
| Medicare PECOS PAC ID | 7416302401 |
|---|---|
| Medicare Enrollment ID | O20231011001883 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376223024 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kevin Robert Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720425234 PECOS PAC ID: 2466736335 Enrollment ID: I20170222000421 |
| Provider Name | Atul Verma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093027989 PECOS PAC ID: 1355562943 Enrollment ID: I20210622000398 |
| Provider Name | Deepthi Surineni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215383807 PECOS PAC ID: 5698069219 Enrollment ID: I20230522002541 |
| Provider Name | Simranjeet Kaur Grewal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255104659 PECOS PAC ID: 4486196771 Enrollment ID: I20240601000002 |
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