| Roshny Pattathu Md Professional Corporation | |
|
999 N Tustin Ave Ste 109 Santa Ana CA 92705-6501 | |
| (714) 775-7700 | |
| (714) 464-2222 |
| Full Name | Roshny Pattathu Md Professional Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 999 N Tustin Ave Ste 109, Santa Ana, California |
| Authorized Official Name and Position | Roshny Pattathu (PRESIDENT) |
| Authorized Official Contact | 9494258735 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roshny Pattathu Md Professional Corporation 17 Momento Irvine CA 92603-4239 Ph: (949) 425-8735 | Roshny Pattathu Md Professional Corporation 999 N Tustin Ave Ste 109 Santa Ana CA 92705-6501 Ph: (714) 775-7700 |
| NPI Number | 1043700776 |
|---|---|
| Provider Enumeration Date | 05/17/2018 |
| Last Update Date | 05/17/2018 |
| Medicare PECOS PAC ID | 6507121852 |
|---|---|
| Medicare Enrollment ID | O20180607001866 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043700776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Roshny A Pattathu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154568350 PECOS PAC ID: 7911044151 Enrollment ID: I20091021000304 |
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