Loomis Medical Clinic | |
6135 King Rd Suite A Loomis CA 95650-8877 | |
(916) 652-0427 | |
(916) 652-4197 |
Full Name | Loomis Medical Clinic |
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Speciality | Family Medicine |
Location | 6135 King Rd, Loomis, California |
Authorized Official Name and Position | Gary Alan Gramm (PHYSICIAN) |
Authorized Official Contact | 9166520427 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Loomis Medical Clinic 6135 King Rd Suite A Loomis CA 95650-8877 Ph: (916) 652-0427 | Loomis Medical Clinic 6135 King Rd Suite A Loomis CA 95650-8877 Ph: (916) 652-0427 |
NPI Number | 1174707921 |
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Provider Enumeration Date | 12/27/2007 |
Last Update Date | 12/27/2007 |
Medicare PECOS PAC ID | 9032304241 |
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Medicare Enrollment ID | O20101113000198 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174707921 | NPI | - | NPPES |
ZZZ94479Z | Other | CA | MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 20A4617 (California) | Primary |
Provider Name | Catherine J Stephens |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043317084 PECOS PAC ID: 3779524186 Enrollment ID: I20050516001054 |
Provider Name | Gary A Gramm |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1235143736 PECOS PAC ID: 8527096627 Enrollment ID: I20050729001019 |