| Chetco Medical & Aesthetics Llc | |
|
97825 Shopping Center Ave Brookings OR 97415-9403 | |
| (541) 412-9800 | |
| (541) 412-9300 |
| Full Name | Chetco Medical & Aesthetics Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 97825 Shopping Center Ave, Brookings, Oregon |
| Authorized Official Name and Position | Palak J Patel (PARTNER) |
| Authorized Official Contact | 5414129800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chetco Medical & Aesthetics Llc Po Box 2742 Brookings OR 97415-0326 Ph: (541) 412-9800 | Chetco Medical & Aesthetics Llc 97825 Shopping Center Ave Brookings OR 97415-9403 Ph: (541) 412-9800 |
| NPI Number | 1316555428 |
|---|---|
| Provider Enumeration Date | 07/15/2020 |
| Last Update Date | 12/17/2020 |
| Medicare PECOS PAC ID | 7113330739 |
|---|---|
| Medicare Enrollment ID | O20201228002189 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316555428 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Jitendra C Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588668230 PECOS PAC ID: 4486618709 Enrollment ID: I20041116001263 |
| Provider Name | Palak J Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922367572 PECOS PAC ID: 9234426180 Enrollment ID: I20180315001788 |
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