| North County Gastroenterology Medical Group, Inc. | |
|
3923 Waring Rd Ste A Oceanside CA 92056-4499 | |
| (760) 727-8782 | |
| (760) 842-7801 |
| Full Name | North County Gastroenterology Medical Group, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 3923 Waring Rd Ste A, Oceanside, California |
| Authorized Official Name and Position | Alexis Michelle Starkel (ADMINISTRATOR) |
| Authorized Official Contact | 7606300529 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North County Gastroenterology Medical Group, Inc. 3923 Waring Rd Ste A Oceanside CA 92056-4499 Ph: (760) 727-8782 | North County Gastroenterology Medical Group, Inc. 3923 Waring Rd Ste A Oceanside CA 92056-4499 Ph: (760) 727-8782 |
| NPI Number | 1710020201 |
|---|---|
| Provider Enumeration Date | 02/14/2007 |
| Last Update Date | 02/25/2021 |
| Medicare PECOS PAC ID | 6406749167 |
|---|---|
| Medicare Enrollment ID | O20040205000899 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710020201 | NPI | - | NPPES |
| 5313715 | Medicaid | CA | |
| ZZZ70529Z | Other | CA | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Javaid Ahmed Shad |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1003885922 PECOS PAC ID: 6709779499 Enrollment ID: I20040205001073 |
| Provider Name | Michael Shim |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1851503353 PECOS PAC ID: 4385718618 Enrollment ID: I20080805000698 |
| Provider Name | Thomas Casimir Krol |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1568431146 PECOS PAC ID: 6901799675 Enrollment ID: I20100519000349 |
| Provider Name | Christopher Emile Devereaux |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376512848 PECOS PAC ID: 6800789579 Enrollment ID: I20100519000465 |
| Provider Name | Matthew Eric Viernes |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1730158650 PECOS PAC ID: 8820981517 Enrollment ID: I20100519000516 |
| Provider Name | Hellen Chiao |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1154681435 PECOS PAC ID: 5890913750 Enrollment ID: I20180405002392 |
| Provider Name | Megan Elisabeth Novo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1770961971 PECOS PAC ID: 3375895709 Enrollment ID: I20181011002354 |
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