| Thvc Medical Group Of Ca Inc | |
|
3928 Waynesboro Ct Stockton CA 95219-3222 | |
| (209) 541-6406 | |
| Not Available |
| Full Name | Thvc Medical Group Of Ca Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3928 Waynesboro Ct, Stockton, California |
| Authorized Official Name and Position | Brian Hess (OWNER/PRESIDENT) |
| Authorized Official Contact | 8656931000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thvc Medical Group Of Ca Inc 265 Brookview Centre Way Ste 400 Knoxville TN 37919-4052 Ph: () - | Thvc Medical Group Of Ca Inc 3928 Waynesboro Ct Stockton CA 95219-3222 Ph: (209) 541-6406 |
| NPI Number | 1487313847 |
|---|---|
| Provider Enumeration Date | 12/14/2021 |
| Last Update Date | 01/24/2023 |
| Medicare PECOS PAC ID | 0143614511 |
|---|---|
| Medicare Enrollment ID | O20220311000095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487313847 | NPI | - | NPPES |
| Provider Name | Alan Leonard Rabideau |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265472419 PECOS PAC ID: 1355353327 Enrollment ID: I20060613000231 |
| Provider Name | Amanda Barnes Bradley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669623740 PECOS PAC ID: 3173686631 Enrollment ID: I20090108000674 |
| Provider Name | Osamede Legemah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184900599 PECOS PAC ID: 6406022193 Enrollment ID: I20111230000121 |
| Provider Name | Katherine Loan Han |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962957415 PECOS PAC ID: 9931291622 Enrollment ID: I20170614002281 |
| Provider Name | Christina N Keith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013431535 PECOS PAC ID: 5395003776 Enrollment ID: I20171212001328 |
| Provider Name | Jonathan Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538647698 PECOS PAC ID: 4981955903 Enrollment ID: I20181001001704 |
| Provider Name | Megan Ryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528566098 PECOS PAC ID: 3870824428 Enrollment ID: I20191011001232 |
| Provider Name | Christopher W Spruell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922462928 PECOS PAC ID: 4880937580 Enrollment ID: I20200407000182 |
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