| |
690 Guzzi Ln Ste B Sonora CA 95370-5289 | |
(209) 536-5060 | |
(209) 533-7696 |
Full Name | |
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Speciality | Internal Medicine |
Location | 690 Guzzi Ln, Sonora, California |
Authorized Official Name and Position | Andrew D. Jahn (VICE PRESIDENT FOR FINANCE) |
Authorized Official Contact | 2095365011 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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14542 Lolly Ln Sonora CA 95370-9226 Ph: (209) 536-2760 | 690 Guzzi Ln Ste B Sonora CA 95370-5289 Ph: (209) 536-5060 |
NPI Number | 1851382675 |
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Provider Enumeration Date | 11/01/2005 |
Last Update Date | 04/04/2013 |
Medicare PECOS PAC ID | 4284538505 |
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Medicare Enrollment ID | O20050329000637 |
Identifier | Type | State | Issuer |
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1851382675 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Douglas W Ankrom |
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Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1558390393 PECOS PAC ID: 5597721795 Enrollment ID: I20041209000244 |
Provider Name | Steven Wunschel |
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Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1396750105 PECOS PAC ID: 8921034612 Enrollment ID: I20090120000458 |
Provider Name | Jason R Jeffery |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1427293836 PECOS PAC ID: 7012109762 Enrollment ID: I20101013000304 |
Provider Name | Rhunjay J Yu |
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Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1255527024 PECOS PAC ID: 7719113745 Enrollment ID: I20131122000781 |
Provider Name | Jason Michael Phillips |
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Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1417120387 PECOS PAC ID: 4486872991 Enrollment ID: I20140825002812 |
Provider Name | Reiker J Schultz |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1285910554 PECOS PAC ID: 7719107341 Enrollment ID: I20141002002648 |
Provider Name | Lincoln J Maynes |
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Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1124055025 PECOS PAC ID: 2668485012 Enrollment ID: I20150110000020 |
Provider Name | Daniel Su |
---|---|
Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1235442534 PECOS PAC ID: 1052548013 Enrollment ID: I20161219002099 |
Provider Name | Daniel T Oberlin |
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Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1184910044 PECOS PAC ID: 6800178674 Enrollment ID: I20170626002191 |
Provider Name | Carlos Alvarez |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1982679239 PECOS PAC ID: 5193799161 Enrollment ID: I20180808002455 |
Provider Name | Jocelyn Moll |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285090902 PECOS PAC ID: 8729382742 Enrollment ID: I20200108000289 |
Sonora Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13951 Mono Way, Suite A, Sonora, CA 95370 Phone: 209-532-3370 Fax: 209-532-3340 | |
Kathy Bosch Chiropractic, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19515 Village Dr, Ste B, Sonora, CA 95370 Phone: 209-533-4330 Fax: 509-532-5374 | |
William E. Zachow, D.o. Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19747 Greenley Rd, Suite S-2, Sonora, CA 95370 Phone: 602-790-4221 | |