| Kavita V Mamtora, MD | |
|
401 Bicentennial Way, Santa Rosa, CA 95403-2149 | |
| (707) 571-4000 | |
| Not Available |
| Full Name | Kavita V Mamtora |
|---|---|
| Gender | Female |
| Speciality | Diagnostic Radiology |
| Experience | 32 Years |
| Location | 401 Bicentennial Way, Santa Rosa, California |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740364728 | NPI | - | NPPES |
| 00A835700 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | A83570 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Kaiser Foundation Hospital-santa Rosa | Santa rosa, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Permanente Medical Group Inc | 8921910225 | 8867 |
| Entity Name | Permanente Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
| Mailing Address | Practice Location Address |
|---|---|
| Kavita V Mamtora, MD 1800 Harrison St Fl 7, Oakland, CA 94612-3466 Ph: (510) 625-6262 | Kavita V Mamtora, MD 401 Bicentennial Way, Santa Rosa, CA 95403-2149 Ph: (707) 571-4000 |
Gary Raymond Roper, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3883 Airway Dr Ste 101, Santa Rosa, CA 95403 Phone: 707-521-4480 Fax: 707-521-4460 | |
Dr. Alvaris W Duffis, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 3325 Chanate Rd, Santa Rosa, CA 95404 Phone: 707-576-4475 | |
Katherine R. Vickery, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 401 Bicentennial Way, Santa Rosa, CA 95403 Phone: 707-571-4000 | |
David Howard Schmidt, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 121 Sotoyome St, Santa Rosa, CA 95405 Phone: 707-546-4062 Fax: 707-578-6258 | |
Dr. Shawn Daly, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 121 Sotoyome St, Santa Rosa, CA 95405 Phone: 707-546-4062 Fax: 707-525-4095 | |
Clifford F Sweet, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 401 Bicentennial Way, Santa Rosa, CA 95403 Phone: 707-569-4740 | |
Gregory P Penning, R.T.(R)(CT)ARRT Radiology Medicare: Not Enrolled in Medicare Practice Location: 30 Mark West Springs Rd, Santa Rosa, CA 95403 Phone: 707-576-4000 |