Sothy L Pheng Md A Professional Corporation | |
2961 Oakberry Ct Fullerton CA 92835-4304 | |
(978) 551-8088 | |
Not Available |
Full Name | Sothy L Pheng Md A Professional Corporation |
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Speciality | Internal Medicine |
Location | 2961 Oakberry Ct, Fullerton, California |
Authorized Official Name and Position | Sothy Lun Pheng (PRESIDENT) |
Authorized Official Contact | 9785518088 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Sothy L Pheng Md A Professional Corporation Po Box 3446 Fullerton CA 92834-3446 Ph: () - | Sothy L Pheng Md A Professional Corporation 2961 Oakberry Ct Fullerton CA 92835-4304 Ph: (978) 551-8088 |
NPI Number | 1407495815 |
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Provider Enumeration Date | 01/02/2020 |
Last Update Date | 01/02/2020 |
Medicare PECOS PAC ID | 1456781855 |
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Medicare Enrollment ID | O20200427002504 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407495815 | NPI | - | NPPES |
2086948 | Medicaid | MA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Sothy L Pheng |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1083697007 PECOS PAC ID: 9638132186 Enrollment ID: I20150424002047 |
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 | |