| Om Medical Inc | |
|
730 17th St Modesto CA 95354-1209 | |
| (209) 943-2000 | |
| Not Available |
| Full Name | Om Medical Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 730 17th St, Modesto, California |
| Authorized Official Name and Position | Manjula Reddy (DIRECTOR) |
| Authorized Official Contact | 2096025599 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Om Medical Inc Po Box 1648 Pleasanton CA 94566-0164 Ph: () - | Om Medical Inc 730 17th St Modesto CA 95354-1209 Ph: (209) 943-2000 |
| NPI Number | 1154766921 |
|---|---|
| Provider Enumeration Date | 05/07/2013 |
| Last Update Date | 07/08/2019 |
| Medicare PECOS PAC ID | 6305076506 |
|---|---|
| Medicare Enrollment ID | O20140310001182 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154766921 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A93135 (California) | Primary |
| Provider Name | Manjula K Reddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750306189 PECOS PAC ID: 5193729937 Enrollment ID: I20060908000280 |
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