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973 University Ave Los Gatos CA 95032-7636 | |
| (408) 871-3200 | |
| (408) 871-3201 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 973 University Ave, Los Gatos, California |
| Authorized Official Name and Position | Richard Ornelas (MEDICAL DIRECTOR) |
| Authorized Official Contact | 4088664000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
973 University Ave Los Gatos CA 95032-7636 Ph: (408) 871-3200 | 973 University Ave Los Gatos CA 95032-7636 Ph: (408) 871-3200 |
| NPI Number | 1578831764 |
|---|---|
| Provider Enumeration Date | 12/02/2011 |
| Last Update Date | 02/17/2021 |
| Medicare PECOS PAC ID | 5991963126 |
|---|---|
| Medicare Enrollment ID | O20120220000829 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578831764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Secondary |
| Provider Name | Vijaya Dudyala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477522589 PECOS PAC ID: 7113995127 Enrollment ID: I20040917000843 |
| Provider Name | Shane Paul Dormady |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1417024654 PECOS PAC ID: 1850306085 Enrollment ID: I20060209000307 |
| Provider Name | Richard A Ornelas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730258229 PECOS PAC ID: 9931206240 Enrollment ID: I20070522000265 |
| Provider Name | Prasanna Menon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417061573 PECOS PAC ID: 0547359010 Enrollment ID: I20071205000717 |
| Provider Name | Karen Y Fann |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1265635023 PECOS PAC ID: 4587733571 Enrollment ID: I20080516000284 |
| Provider Name | Catherine A Collings |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447253349 PECOS PAC ID: 0042360489 Enrollment ID: I20090605000497 |
| Provider Name | Deborah J Freehling |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1629246798 PECOS PAC ID: 6507053394 Enrollment ID: I20101206000800 |
| Provider Name | Addy Squarer |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1679581425 PECOS PAC ID: 8123181674 Enrollment ID: I20120717000526 |
| Provider Name | Jiali Li |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1396981445 PECOS PAC ID: 0749432276 Enrollment ID: I20121210000212 |
| Provider Name | Shiva R Singhal |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1942456389 PECOS PAC ID: 7416089651 Enrollment ID: I20140604002592 |
| Provider Name | Yazeed M Gussous |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1891969184 PECOS PAC ID: 9032351382 Enrollment ID: I20140826002968 |
| Provider Name | Maria K Teng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174848295 PECOS PAC ID: 5496888315 Enrollment ID: I20140829002244 |
| Provider Name | Anahid Hekmat |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1134325467 PECOS PAC ID: 5496990483 Enrollment ID: I20141203000034 |
| Provider Name | Kimberly Joyce Erlich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104852532 PECOS PAC ID: 0749366706 Enrollment ID: I20150730010906 |
| Provider Name | Sabiya Banu Raja |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992098701 PECOS PAC ID: 7810206596 Enrollment ID: I20151020001304 |
| Provider Name | Katherine Vereeke Kuhl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497076467 PECOS PAC ID: 5890096622 Enrollment ID: I20170403001127 |
| Provider Name | Charlyne Julao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457710527 PECOS PAC ID: 2365736279 Enrollment ID: I20180322001129 |
| Provider Name | Mathilde Moazazi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366671224 PECOS PAC ID: 5991980286 Enrollment ID: I20180323000343 |
| Provider Name | Divya Prabhu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1285921155 PECOS PAC ID: 6709141930 Enrollment ID: I20180517001623 |
| Provider Name | Katrina Chaung |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1487810990 PECOS PAC ID: 7416197090 Enrollment ID: I20181218002432 |
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