| Telefamilydoc | |
|
15195 National Ave Ste 205 Los Gatos CA 95032-2631 | |
| (408) 345-5494 | |
| (623) 666-6760 |
| Full Name | Telefamilydoc |
|---|---|
| Speciality | Family Medicine |
| Location | 15195 National Ave Ste 205, Los Gatos, California |
| Authorized Official Name and Position | Alex Mirabadi (CEO) |
| Authorized Official Contact | 4083546760 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Telefamilydoc 481 N Santa Cruz Ave Ste 130 Los Gatos CA 95030-5300 Ph: (408) 345-5494 | Telefamilydoc 15195 National Ave Ste 205 Los Gatos CA 95032-2631 Ph: (408) 345-5494 |
| NPI Number | 1699559781 |
|---|---|
| Provider Enumeration Date | 08/21/2023 |
| Last Update Date | 09/18/2023 |
| Medicare PECOS PAC ID | 5991150278 |
|---|---|
| Medicare Enrollment ID | O20231005001983 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699559781 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Alex A Mirabadi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396037545 PECOS PAC ID: 0840512315 Enrollment ID: I20231005002082 |
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