Tet Toe Md Inc | |
1580 Creekside Dr Suite 130 Folsom CA 95630-3886 | |
(916) 542-1458 | |
(916) 542-1456 |
Full Name | Tet Toe Md Inc |
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Speciality | Clinic/Center |
Location | 1580 Creekside Dr, Folsom, California |
Authorized Official Name and Position | Angela Graves (OFFICE MANAGER) |
Authorized Official Contact | 9165421458 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tet Toe Md Inc 1580 Creekside Dr Suite 130 Folsom CA 95630-3886 Ph: (916) 542-1458 | Tet Toe Md Inc 1580 Creekside Dr Suite 130 Folsom CA 95630-3886 Ph: (916) 542-1458 |
NPI Number | 1639618481 |
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Provider Enumeration Date | 02/13/2017 |
Last Update Date | 02/13/2017 |
Medicare PECOS PAC ID | 2062797350 |
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Medicare Enrollment ID | O20170329001462 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639618481 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | A105047 (California) | Primary |
Provider Name | Tet Toe |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1710132733 PECOS PAC ID: 4486707973 Enrollment ID: I20090730000570 |
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