| Keith Leibowitz M.d. A Professional Corporation | |
|
203 Park Ave Modesto CA 95354-0557 | |
| (757) 645-7079 | |
| Not Available |
| Full Name | Keith Leibowitz M.d. A Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 203 Park Ave, Modesto, California |
| Authorized Official Name and Position | Keith A Leibowitz (OWNER) |
| Authorized Official Contact | 7576457079 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keith Leibowitz M.d. A Professional Corporation 203 Park Ave Modesto CA 95354-0557 Ph: (757) 645-7079 | Keith Leibowitz M.d. A Professional Corporation 203 Park Ave Modesto CA 95354-0557 Ph: (757) 645-7079 |
| NPI Number | 1033989652 |
|---|---|
| Provider Enumeration Date | 01/04/2024 |
| Last Update Date | 01/04/2024 |
| Medicare PECOS PAC ID | 8224478722 |
|---|---|
| Medicare Enrollment ID | O20240501001764 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033989652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Keith Alan Leibowitz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1083689335 PECOS PAC ID: 6305889148 Enrollment ID: I20151123001316 |
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