| Bayview Gastroenterology Medical Corporation | |
|
4145 Clares St Ste A Capitola CA 95010-2053 | |
| (831) 662-9999 | |
| (831) 662-9998 |
| Full Name | Bayview Gastroenterology Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 4145 Clares St, Capitola, California |
| Authorized Official Name and Position | Ali Khademi (PHYSICIAN) |
| Authorized Official Contact | 8316629999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bayview Gastroenterology Medical Corporation 4145 Clares St Ste A Capitola CA 95010-2053 Ph: (831) 662-9999 | Bayview Gastroenterology Medical Corporation 4145 Clares St Ste A Capitola CA 95010-2053 Ph: (831) 662-9999 |
| NPI Number | 1306006879 |
|---|---|
| Provider Enumeration Date | 06/09/2008 |
| Last Update Date | 12/13/2016 |
| Medicare PECOS PAC ID | 5395807515 |
|---|---|
| Medicare Enrollment ID | O20081223000300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306006879 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 20A7421 (California) | Primary |
| Provider Name | Ali Khademi |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1427121037 PECOS PAC ID: 7416996715 Enrollment ID: I20050426001465 |
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