| Gautami Agastya, Md., Inc. | |
|
652 W 11th St Suite 137 Tracy CA 95376-3869 | |
| (209) 833-7555 | |
| (209) 833-7518 |
| Full Name | Gautami Agastya, Md., Inc. |
|---|---|
| Speciality | Preventive Medicine |
| Location | 652 W 11th St, Tracy, California |
| Authorized Official Name and Position | Gautami Agastya (PRESIDENT) |
| Authorized Official Contact | 2098337555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gautami Agastya, Md., Inc. 652 W 11th St Suite 137 Tracy CA 95376-3869 Ph: (209) 833-7555 | Gautami Agastya, Md., Inc. 652 W 11th St Suite 137 Tracy CA 95376-3869 Ph: (209) 833-7555 |
| NPI Number | 1659540870 |
|---|---|
| Provider Enumeration Date | 02/21/2008 |
| Last Update Date | 02/13/2013 |
| Medicare PECOS PAC ID | 3375605348 |
|---|---|
| Medicare Enrollment ID | O20090806000743 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659540870 | NPI | - | NPPES |
| Provider Name | Gautami Agastya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356312516 PECOS PAC ID: 3577477223 Enrollment ID: I20031219000693 |
| Provider Name | Ramana Adapa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407959315 PECOS PAC ID: 3870663404 Enrollment ID: I20080609000208 |
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