| Pasadena Gastroenterology Medical Group Inc | |
|
2750 E Washington Blvd Ste 330 Pasadena CA 91107-1448 | |
| (626) 797-9883 | |
| Not Available |
| Full Name | Pasadena Gastroenterology Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2750 E Washington Blvd, Pasadena, California |
| Authorized Official Name and Position | Bea Thomas (OFFICE MANAGER) |
| Authorized Official Contact | 6267979883 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pasadena Gastroenterology Medical Group Inc 2750 E. Washington Blvd Ste 330 Pasadena CA 91107 Ph: (626) 797-9883 | Pasadena Gastroenterology Medical Group Inc 2750 E Washington Blvd Ste 330 Pasadena CA 91107-1448 Ph: (626) 797-9883 |
| NPI Number | 1487855086 |
|---|---|
| Provider Enumeration Date | 05/30/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0941333009 |
|---|---|
| Medicare Enrollment ID | O20100727000514 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487855086 | NPI | - | NPPES |
| GROO29750 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Issac A Bartley |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1710088729 PECOS PAC ID: 8729175740 Enrollment ID: I20130312000319 |
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