| Family Medicine Online | |
|
1113 S Park Victoria Dr Milpitas CA 95035-6942 | |
| (408) 945-0300 | |
| (408) 946-7533 |
| Full Name | Family Medicine Online |
|---|---|
| Speciality | Family Medicine |
| Location | 1113 S Park Victoria Dr, Milpitas, California |
| Authorized Official Name and Position | Shivani Chawla Mehta (OWNER) |
| Authorized Official Contact | 4089450300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Online 1113 S Park Victoria Dr Milpitas CA 95035-6942 Ph: (408) 945-0300 | Family Medicine Online 1113 S Park Victoria Dr Milpitas CA 95035-6942 Ph: (408) 945-0300 |
| NPI Number | 1992411946 |
|---|---|
| Provider Enumeration Date | 01/24/2023 |
| Last Update Date | 01/24/2023 |
| Medicare PECOS PAC ID | 6709258163 |
|---|---|
| Medicare Enrollment ID | O20230211000326 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992411946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Shivani Chawla-mehta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659513398 PECOS PAC ID: 3274778790 Enrollment ID: I20130403000331 |
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