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1321 N Harbor Blvd Ste 302 Fullerton CA 92835-4131 | |
(714) 441-0591 | |
(714) 441-0594 |
Full Name | |
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Speciality | Internal Medicine |
Location | 1321 N Harbor Blvd Ste 302, Fullerton, California |
Authorized Official Name and Position | Rajiv I Bhavsar (PRESIDENT/ OWNER) |
Authorized Official Contact | 7144410591 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1321 N Harbor Blvd Ste 302 Fullerton CA 92835-4131 Ph: (714) 441-0591 | 1321 N Harbor Blvd Ste 302 Fullerton CA 92835-4131 Ph: (714) 441-0591 |
NPI Number | 1144515099 |
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Provider Enumeration Date | 06/17/2011 |
Last Update Date | 12/12/2011 |
Medicare PECOS PAC ID | 4082881990 |
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Medicare Enrollment ID | O20120118000090 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144515099 | NPI | - | NPPES |
00C507170 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | C50717 (California) | Primary |
Provider Name | Rajiv I Bhavsar |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1477550648 PECOS PAC ID: 7618905456 Enrollment ID: I20050802000573 |
Uma P Rao, Md., Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1400 N Harbor Blvd, Suite 120, Fullerton, CA 92835 Phone: 714-992-2765 Fax: 714-681-9015 | |