| Dr Michael Dennis Kifune, MD | |
|
1333 Highway 49, San Andreas, CA 95249-9618 | |
| (209) 755-1400 | |
| (209) 755-1430 |
| Full Name | Dr Michael Dennis Kifune |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 1333 Highway 49, San Andreas, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578568614 | NPI | - | NPPES |
| 00G398330 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G39833 (California) | Primary |
| Entity Name | Mark Twain Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508968819 PECOS PAC ID: 8820073711 Enrollment ID: O20061006000227 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael Dennis Kifune, MD Po Box 939, Angels Camp, CA 95222-0939 Ph: (209) 754-6240 | Dr Michael Dennis Kifune, MD 1333 Highway 49, San Andreas, CA 95249-9618 Ph: (209) 755-1400 |
Matthew Joshua King-lung Kor, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 702 Mountain Ranch Rd, San Andreas, CA 95249 Phone: 092-754-4564 Fax: 209-942-3462 | |
Dr. Shane Michael Patterson, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 702 Mountain Ranch Rd, San Andreas, CA 95249 Phone: 209-754-0870 Fax: 209-754-0878 | |
Mr. Dean Matthew Kelaita, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 702 Mountain Ranch Rd., San Andreas, CA 95249 Phone: 209-754-0870 Fax: 209-754-0878 | |
Mrs. Sarah Margaret Grimes, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 702 Mountain Ranch Rd, San Andreas, CA 95249 Phone: 209-754-0870 Fax: 209-754-0878 |