| Placer Medical Center, Inc | |
|
576 N Sunrise Ave Ste 210 Roseville CA 95661-2847 | |
| (916) 786-0222 | |
| Not Available |
| Full Name | Placer Medical Center, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 576 N Sunrise Ave Ste 210, Roseville, California |
| Authorized Official Name and Position | Shailaja Menon (PRESIDENT) |
| Authorized Official Contact | 9165088852 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Placer Medical Center, Inc 3843 Mountainview Dr Loomis CA 95650-9796 Ph: (916) 508-8852 | Placer Medical Center, Inc 576 N Sunrise Ave Ste 210 Roseville CA 95661-2847 Ph: (916) 786-0222 |
| NPI Number | 1962907436 |
|---|---|
| Provider Enumeration Date | 03/27/2018 |
| Last Update Date | 03/27/2018 |
| Medicare PECOS PAC ID | 6709133564 |
|---|---|
| Medicare Enrollment ID | O20180725000633 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962907436 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A81351 (California) | Primary |
| Provider Name | Shailaja Vemulapalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346223443 PECOS PAC ID: 1052687233 Enrollment ID: I20171017001249 |
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