Shantharam Pai, MD | |
511 Amigos Dr Ste C, Redlands, CA 92373-6283 | |
(909) 799-7111 | |
(909) 498-5154 |
Full Name | Shantharam Pai |
---|---|
Gender | Male |
Speciality | Family Medicine - Geriatric Medicine |
Location | 511 Amigos Dr Ste C, Redlands, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053317537 | NPI | - | NPPES |
00A442860 | Other | CA | BLUE SHIELD OF CA |
CA131554 | Other | CA | MEDICARE |
00A442861 | Medicaid | CA | |
080101190 | Other | GA | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QG0300X | Family Medicine - Geriatric Medicine | A442860 (California) | Primary |
207Q00000X | Family Medicine | A442860 (California) | Secondary |
Entity Name | Beaver Medical Group Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649503319 PECOS PAC ID: 0547164295 Enrollment ID: O20031124000449 |
Mailing Address | Practice Location Address |
---|---|
Shantharam Pai, MD 511 Amigos Dr Ste C, Redlands, CA 92373-6283 Ph: (909) 799-7111 | Shantharam Pai, MD 511 Amigos Dr Ste C, Redlands, CA 92373-6283 Ph: (909) 799-7111 |
Salma Mohammadi Green, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 245 Terracina Blvd Ste 102, Redlands, CA 92373 Phone: 909-792-2605 | |
Dr. Katrina Carter, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1600 E Citrus Ave, Redlands, CA 92374 Phone: 909-794-3682 | |
Calvin G Hagglov, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 25828 Redlands Blvd Ste 102, Redlands, CA 92373 Phone: 909-558-6600 | |
Grace Marie Hecker, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1910 Orange Tree Ln Ste 344, Redlands, CA 92374 Phone: 909-792-1388 Fax: 097-487-9259 | |
Dr. Veena Mysore, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 25828 Redlands Blvd Ste 102, Redlands, CA 92373 Phone: 909-558-6600 | |
Horst R Rudrich, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 255 Terracina Blvd, Ste. 105, Redlands, CA 92373 Phone: 909-793-0323 Fax: 909-793-9173 |