Medicus Vip | |
100 N Wiget Ln Ste 200 Walnut Creek CA 94598-5901 | |
(773) 632-7244 | |
Not Available |
Full Name | Medicus Vip |
---|---|
Speciality | Clinic/center - Multi-specialty |
Location | 100 N Wiget Ln Ste 200, Walnut Creek, California |
Authorized Official Name and Position | Eric S Kenley (OWNER) |
Authorized Official Contact | 7736327244 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Medicus Vip 100 N Wiget Ln Ste 200 Walnut Creek CA 94598-5901 Ph: (773) 632-7244 | Medicus Vip 100 N Wiget Ln Ste 200 Walnut Creek CA 94598-5901 Ph: (773) 632-7244 |
NPI Number | 1396261582 |
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Provider Enumeration Date | 08/18/2017 |
Last Update Date | 07/21/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396261582 | NPI | - | NPPES |
1194847475 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | A100640 (California) | Primary |
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