| Prithvi Shankar, M.d., Inc | |
|
400 E Orangeburg Ave Ste 13 Modesto CA 95350-5342 | |
| (209) 578-1600 | |
| (209) 578-1088 |
| Full Name | Prithvi Shankar, M.d., Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 400 E Orangeburg Ave, Modesto, California |
| Authorized Official Name and Position | Prithvi N Shankar (OWNER/PRESIDENT) |
| Authorized Official Contact | 2095781600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prithvi Shankar, M.d., Inc Po Box 579225 Modesto CA 95357-9225 Ph: (209) 578-1600 | Prithvi Shankar, M.d., Inc 400 E Orangeburg Ave Ste 13 Modesto CA 95350-5342 Ph: (209) 578-1600 |
| NPI Number | 1750655429 |
|---|---|
| Provider Enumeration Date | 02/28/2012 |
| Last Update Date | 10/15/2012 |
| Medicare PECOS PAC ID | 4688834450 |
|---|---|
| Medicare Enrollment ID | O20120402000428 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750655429 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A92177 (California) | Primary |
| Provider Name | Prithvi N Shankar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790772838 PECOS PAC ID: 2961431614 Enrollment ID: I20050811001144 |
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