Geriguidemd Llc | |
19565 Aster Ln Bend OR 97702-2111 | |
(801) 718-3808 | |
Not Available |
Full Name | Geriguidemd Llc |
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Speciality | Internal Medicine |
Location | 19565 Aster Ln, Bend, Oregon |
Authorized Official Name and Position | Sonal Sonia Thakur (CMD/GERIATRICS) |
Authorized Official Contact | 8017183808 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Geriguidemd Llc 19565 Aster Ln Bend OR 97702-2111 Ph: (801) 718-3808 | Geriguidemd Llc 19565 Aster Ln Bend OR 97702-2111 Ph: (801) 718-3808 |
NPI Number | 1538670732 |
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Provider Enumeration Date | 10/16/2017 |
Last Update Date | 10/16/2017 |
Medicare PECOS PAC ID | 0941569651 |
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Medicare Enrollment ID | O20180125000563 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538670732 | NPI | - | NPPES |
000000000 | Other | NO INSURERS YET |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0300X | Internal Medicine - Geriatric Medicine | MD152920 (Oregon) | Primary |
Provider Name | Sonal S Thakur |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1831353226 PECOS PAC ID: 1153481965 Enrollment ID: I20110408000685 |
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