| Los Gatos Premier Medicine Pc | |
|
15251 National Ave Unit 104 Los Gatos CA 95032-2400 | |
| (408) 358-7360 | |
| (408) 358-7357 |
| Full Name | Los Gatos Premier Medicine Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 15251 National Ave Unit 104, Los Gatos, California |
| Authorized Official Name and Position | Jennifer Haggerty (OWNER) |
| Authorized Official Contact | 4086467388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Los Gatos Premier Medicine Pc 15251 National Ave Ste 104 Los Gatos CA 95032-2400 Ph: (408) 358-7360 | Los Gatos Premier Medicine Pc 15251 National Ave Unit 104 Los Gatos CA 95032-2400 Ph: (408) 358-7360 |
| NPI Number | 1548908098 |
|---|---|
| Provider Enumeration Date | 05/24/2022 |
| Last Update Date | 06/09/2022 |
| Medicare PECOS PAC ID | 3375924210 |
|---|---|
| Medicare Enrollment ID | O20220722002194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548908098 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jennifer Diane Haggerty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366779977 PECOS PAC ID: 1153465976 Enrollment ID: I20100217000677 |
| Provider Name | Rachel Ann Edquilang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730899600 PECOS PAC ID: 3678943768 Enrollment ID: I20230106000235 |
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