| Hamilton Avenue Medical Group, Inc. | |
|
295 Oconnor Dr San Jose CA 95128-1624 | |
| (408) 279-8171 | |
| (408) 279-0412 |
| Full Name | Hamilton Avenue Medical Group, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 295 Oconnor Dr, San Jose, California |
| Authorized Official Name and Position | Jean Luong (PRESIDENT) |
| Authorized Official Contact | 4082798171 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hamilton Avenue Medical Group, Inc. 295 Oconnor Dr San Jose CA 95128-1624 Ph: (408) 279-8171 | Hamilton Avenue Medical Group, Inc. 295 Oconnor Dr San Jose CA 95128-1624 Ph: (408) 279-8171 |
| NPI Number | 1871712737 |
|---|---|
| Provider Enumeration Date | 04/25/2007 |
| Last Update Date | 07/22/2015 |
| Medicare PECOS PAC ID | 1951349182 |
|---|---|
| Medicare Enrollment ID | O20050419000968 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871712737 | NPI | - | NPPES |
| ZZZ73614Z | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A48809 (California) | Primary |
| Provider Name | Masha Nakelchik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255346623 PECOS PAC ID: 1153369376 Enrollment ID: I20050419000936 |
| Provider Name | David Alan Cahn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689762205 PECOS PAC ID: 7315951027 Enrollment ID: I20060202000189 |
| Provider Name | Jean F Luong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780615641 PECOS PAC ID: 0941478366 Enrollment ID: I20110729000187 |
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