| Kings Medical Group Pc | |
|
808 Vaughn St Hanford CA 93230 | |
| (559) 410-8404 | |
| Not Available |
| Full Name | Kings Medical Group Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 808 Vaughn St, Hanford, California |
| Authorized Official Name and Position | John R Gavini (PRESIDENT) |
| Authorized Official Contact | 5594108404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kings Medical Group Pc 240 N 12th Ave Suite 109 #303 Hanford CA 93230-5995 Ph: (559) 410-8404 | Kings Medical Group Pc 808 Vaughn St Hanford CA 93230 Ph: (559) 410-8404 |
| NPI Number | 1972919116 |
|---|---|
| Provider Enumeration Date | 07/09/2014 |
| Last Update Date | 12/05/2016 |
| Medicare PECOS PAC ID | 5092937573 |
|---|---|
| Medicare Enrollment ID | O20141118001334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972919116 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A77882 (California) | Primary |
| Provider Name | Asela D Wickremasinghe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164476081 PECOS PAC ID: 5799676292 Enrollment ID: I20040325000703 |
| Provider Name | John R Gavini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750328803 PECOS PAC ID: 2567353071 Enrollment ID: I20040325000955 |
| Provider Name | Sudesh Nagavalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780629691 PECOS PAC ID: 9537114103 Enrollment ID: I20050316000568 |
Adventist Health Physicians Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1524 W Lacey Blvd, 202, Hanford, CA 93230 Phone: 559-583-4560 Fax: 559-583-4561 | |
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