| Los Gatos Doc, Inc. | |
|
15195 National Ave Suite 205 Los Gatos CA 95032-2631 | |
| (408) 502-6040 | |
| (408) 502-6041 |
| Full Name | Los Gatos Doc, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 15195 National Ave, Los Gatos, California |
| Authorized Official Name and Position | Arun Villivalam (PRESIDENT) |
| Authorized Official Contact | 4085026040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Los Gatos Doc, Inc. 15195 National Ave Suite 205 Los Gatos CA 95032-2631 Ph: (408) 502-6040 | Los Gatos Doc, Inc. 15195 National Ave Suite 205 Los Gatos CA 95032-2631 Ph: (408) 502-6040 |
| NPI Number | 1245685130 |
|---|---|
| Provider Enumeration Date | 04/28/2016 |
| Last Update Date | 06/15/2016 |
| Medicare PECOS PAC ID | 1355632126 |
|---|---|
| Medicare Enrollment ID | O20160627000073 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245685130 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 73520 (California) | Primary |
| Provider Name | Arun Villivalam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639355944 PECOS PAC ID: 3971558727 Enrollment ID: I20131017000361 |
| Provider Name | Meghana Bachu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588287676 PECOS PAC ID: 6507286002 Enrollment ID: I20221006002788 |
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