| John Kelada M.d., Inc. | |
|
1000 Camerado Dr Cameron Park CA 95682-8864 | |
| (530) 677-3688 | |
| Not Available |
| Full Name | John Kelada M.d., Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1000 Camerado Dr, Cameron Park, California |
| Authorized Official Name and Position | John Mina Kelada (PRESIDENT) |
| Authorized Official Contact | 5306773688 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John Kelada M.d., Inc. Po Box 455 Shingle Springs CA 95682-0455 Ph: (530) 677-3688 | John Kelada M.d., Inc. 1000 Camerado Dr Cameron Park CA 95682-8864 Ph: (530) 677-3688 |
| NPI Number | 1013425495 |
|---|---|
| Provider Enumeration Date | 01/18/2018 |
| Last Update Date | 08/14/2022 |
| Medicare PECOS PAC ID | 3870856743 |
|---|---|
| Medicare Enrollment ID | O20180406002045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013425495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | A125118 (California) | Primary |
| Provider Name | John Mina Kelada |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1861703530 PECOS PAC ID: 6002194412 Enrollment ID: I20180406002098 |
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