Urgent Doc Pro | |
3334 Lantern Way San Jose CA 95111-1317 | |
(408) 202-1962 | |
Not Available |
Full Name | Urgent Doc Pro |
---|---|
Speciality | Clinic/Center |
Location | 3334 Lantern Way, San Jose, California |
Authorized Official Name and Position | Eileen V Moy (PRESIDENT) |
Authorized Official Contact | 4082021962 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Urgent Doc Pro 3334 Lantern Way San Jose CA 95111-1317 Ph: (408) 202-1962 | Urgent Doc Pro 3334 Lantern Way San Jose CA 95111-1317 Ph: (408) 202-1962 |
NPI Number | 1376167700 |
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Provider Enumeration Date | 06/01/2020 |
Last Update Date | 04/05/2021 |
Medicare PECOS PAC ID | 6800208497 |
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Medicare Enrollment ID | O20210310002671 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376167700 | NPI | - | NPPES |
1083617583 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Eileen V Moy |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1083617583 PECOS PAC ID: 0941248108 Enrollment ID: I20050419001223 |
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