| Danesh Medical Office Pc | |
|
1600 Creekside Dr Suite 3600 Folsom CA 95630-3444 | |
| (916) 984-6100 | |
| (916) 984-6129 |
| Full Name | Danesh Medical Office Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1600 Creekside Dr, Folsom, California |
| Authorized Official Name and Position | Wali A Danesh (PRESIDENT) |
| Authorized Official Contact | 9169846100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Danesh Medical Office Pc 1600 Creekside Dr Ste 3600 Folsom CA 95630-3446 Ph: (916) 984-6100 | Danesh Medical Office Pc 1600 Creekside Dr Suite 3600 Folsom CA 95630-3444 Ph: (916) 984-6100 |
| NPI Number | 1841409612 |
|---|---|
| Provider Enumeration Date | 05/21/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5092776633 |
|---|---|
| Medicare Enrollment ID | O20041026000789 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841409612 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A75706 (California) | Primary |
| Provider Name | Wali A Danesh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598789463 PECOS PAC ID: 9335100973 Enrollment ID: I20041026000868 |
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