| Tremayne Center For Medicine | |
|
817 Coffee Rd Suite D Modesto CA 95355-4241 | |
| (209) 549-1600 | |
| (209) 549-1601 |
| Full Name | Tremayne Center For Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 817 Coffee Rd, Modesto, California |
| Authorized Official Name and Position | Paula Tremayne (PRESIDENT) |
| Authorized Official Contact | 2095491600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tremayne Center For Medicine 817 Coffee Rd Suite D Modesto CA 95355-4241 Ph: (209) 549-1600 | Tremayne Center For Medicine 817 Coffee Rd Suite D Modesto CA 95355-4241 Ph: (209) 549-1600 |
| NPI Number | 1629346630 |
|---|---|
| Provider Enumeration Date | 12/05/2011 |
| Last Update Date | 01/11/2017 |
| Medicare PECOS PAC ID | 7517124159 |
|---|---|
| Medicare Enrollment ID | O20120208001044 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629346630 | NPI | - | NPPES |
| 020A84952 | Other | CA | MCARE PTAN |
| 00AX84950 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 20A8495 (California) | Primary |
| 207RH0002X | Internal Medicine - Hospice And Palliative Medicine | 20A8495 (California) | Secondary |
| Provider Name | Paula S Tremayne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740368554 PECOS PAC ID: 5193781292 Enrollment ID: I20041209000339 |
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