Avita Md | |
827 Altos Oaks Dr Ste 4 Los Altos CA 94024-5490 | |
(408) 495-5770 | |
(650) 912-1129 |
Full Name | Avita Md |
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Speciality | Internal Medicine |
Location | 827 Altos Oaks Dr Ste 4, Los Altos, California |
Authorized Official Name and Position | Patricia Sitnitsky (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 4084955770 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Avita Md 827 Altos Oaks Dr Ste 4 Los Altos CA 94024-5490 Ph: (408) 495-5770 | Avita Md 827 Altos Oaks Dr Ste 4 Los Altos CA 94024-5490 Ph: (408) 495-5770 |
NPI Number | 1265121669 |
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Provider Enumeration Date | 05/02/2023 |
Last Update Date | 07/15/2023 |
Medicare PECOS PAC ID | 0446619852 |
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Medicare Enrollment ID | O20230703001946 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265121669 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Patricia Roukee Sitnitsky |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1790896231 PECOS PAC ID: 3971547829 Enrollment ID: I20050613000617 |
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