| Terrell B Vanaken Md Inc | |
|
167 Bounty Ln Vacaville CA 95687-3120 | |
| (707) 694-2623 | |
| Not Available |
| Full Name | Terrell B Vanaken Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 167 Bounty Ln, Vacaville, California |
| Authorized Official Name and Position | Terrell B Vanaken (OWNER) |
| Authorized Official Contact | 7076942623 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Terrell B Vanaken Md Inc 167 Bounty Ln Vacaville CA 95687-3120 Ph: (707) 694-2623 | Terrell B Vanaken Md Inc 167 Bounty Ln Vacaville CA 95687-3120 Ph: (707) 694-2623 |
| NPI Number | 1770271264 |
|---|---|
| Provider Enumeration Date | 04/24/2023 |
| Last Update Date | 01/31/2024 |
| Medicare PECOS PAC ID | 8820455447 |
|---|---|
| Medicare Enrollment ID | O20230613000458 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770271264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Terrell B Van Aken |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306941430 PECOS PAC ID: 0244367969 Enrollment ID: I20100428000471 |
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