| Raj Menon, Md,inc | |
|
3620 S Bristol St Ste 102 Santa Ana CA 92704-7314 | |
| (714) 556-6666 | |
| (714) 556-4548 |
| Full Name | Raj Menon, Md,inc |
|---|---|
| Speciality | Family Medicine |
| Location | 3620 S Bristol St Ste 102, Santa Ana, California |
| Authorized Official Name and Position | Raj Menon (OFFICER) |
| Authorized Official Contact | 7145566666 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Raj Menon, Md,inc 3620 S Bristol St Ste 102 Santa Ana CA 92704-7314 Ph: (714) 556-6666 | Raj Menon, Md,inc 3620 S Bristol St Ste 102 Santa Ana CA 92704-7314 Ph: (714) 556-6666 |
| NPI Number | 1497079883 |
|---|---|
| Provider Enumeration Date | 03/15/2010 |
| Last Update Date | 03/15/2010 |
| Medicare PECOS PAC ID | 5496880049 |
|---|---|
| Medicare Enrollment ID | O20100322000144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497079883 | NPI | - | NPPES |
| 1316014954 | Other | INDIVIDUAL NPI PROVIDER NUMBER | |
| 00A38792 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A38792 (California) | Primary |
| Provider Name | Raj Menon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316014954 PECOS PAC ID: 3173547395 Enrollment ID: I20080116000328 |
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