| Shota Gurtch, M.d., Inc. A Professional Corporation | |
|
8875 La Mesa Blvd Ste C La Mesa CA 91942-5434 | |
| (619) 668-8100 | |
| (619) 667-2688 |
| Full Name | Shota Gurtch, M.d., Inc. A Professional Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 8875 La Mesa Blvd Ste C, La Mesa, California |
| Authorized Official Name and Position | Shota Gurchumelidze (PHYSICIAN) |
| Authorized Official Contact | 8589973161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shota Gurtch, M.d., Inc. A Professional Corporation 8875 La Mesa Blvd Ste C La Mesa CA 91942-5434 Ph: (619) 668-8100 | Shota Gurtch, M.d., Inc. A Professional Corporation 8875 La Mesa Blvd Ste C La Mesa CA 91942-5434 Ph: (619) 668-8100 |
| NPI Number | 1154050904 |
|---|---|
| Provider Enumeration Date | 06/07/2022 |
| Last Update Date | 08/31/2023 |
| Medicare PECOS PAC ID | 1254795578 |
|---|---|
| Medicare Enrollment ID | O20230919003294 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154050904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Shota Gurchumelidze |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821284449 PECOS PAC ID: 0941381628 Enrollment ID: I20080118000669 |
Nadi Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4535 70th St, La Mesa, CA 91942 Phone: 619-750-4962 | |
Shota Gurtch, M.d., Inc., A Professional Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8875 La Mesa Blvd Ste C, La Mesa, CA 91942 Phone: 619-668-8100 | |
Michael Andrisani Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8600 La Mesa Blvd, La Mesa, CA 91941 Phone: 619-469-3822 | |
Mohammed Miradi Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5565 Grossmont Center Dr, Ste 211, La Mesa, CA 91942 Phone: 619-644-1483 | |
Encompass Family And Internal Medicine Group Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7051 Alvarado Rd, 201, La Mesa, CA 91942 Phone: 619-460-7775 Fax: 858-519-5446 | |
Dap Health-la Mesa Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8881 Fletcher Pkwy Ste 200, La Mesa, CA 91942 Phone: 619-464-6434 Fax: 619-464-5109 | |
Raed Al-naser, M.d., A Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5525 Grossmont Center Dr Ste 609, La Mesa, CA 91942 Phone: 619-589-9158 Fax: 619-462-0371 |