| Kent Family Medical Clinic Llc | |
|
10830 Se Kent Kangley Rd 100a Kent WA 98030-9959 | |
| (253) 520-7390 | |
| (253) 520-7028 |
| Full Name | Kent Family Medical Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 10830 Se Kent Kangley Rd, Kent, Washington |
| Authorized Official Name and Position | Harpreet Singh Chhokar (MEMBER/MANAGER) |
| Authorized Official Contact | 2535207390 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kent Family Medical Clinic Llc 12932 Se Kent Kangley Rd 184 Kent WA 98030-7940 Ph: (253) 520-7390 | Kent Family Medical Clinic Llc 10830 Se Kent Kangley Rd 100a Kent WA 98030-9959 Ph: (253) 520-7390 |
| NPI Number | 1407800956 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 11/06/2007 |
| Medicare PECOS PAC ID | 0648281014 |
|---|---|
| Medicare Enrollment ID | O20060523000043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407800956 | NPI | - | NPPES |
| 7132822 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD00045566 (Washington) | Primary |
| Provider Name | Harpreet Singh Chhokar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194779629 PECOS PAC ID: 6608891825 Enrollment ID: I20051006000929 |
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