| Dr Mark T Keidel, MD, MPH | |
|
3102 E Highland Ave # Admin150, Patton, CA 92369-7813 | |
| (909) 425-7000 | |
| (909) 425-6169 |
| Full Name | Dr Mark T Keidel |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 3102 E Highland Ave # Admin150, Patton, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134154263 | NPI | - | NPPES |
| 00A769370 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A76937 (California) | Primary |
| Entity Name | Beaver Medical Group P C |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649503319 PECOS PAC ID: 0547164295 Enrollment ID: O20031124000449 |
| Entity Name | Department Of State Hospitals |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124078704 PECOS PAC ID: 9638174238 Enrollment ID: O20081031000305 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mark T Keidel, MD, MPH 3102 E Highland Ave # Admin150, Patton, CA 92369-7813 Ph: (909) 254-8279 | Dr Mark T Keidel, MD, MPH 3102 E Highland Ave # Admin150, Patton, CA 92369-7813 Ph: (909) 425-7000 |
Marianita Aralar Raymundo, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 3102 E. Highland Avenue, Medical Staff Office, Patton, CA 92369 Phone: 909-425-7000 | |
Mrs. Stephanie Anh-hang Nguyen, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3102 E. Highland Avenue, Medical Staff Office, Patton, CA 92369 Phone: 909-425-7679 Fax: 909-425-6635 | |
Trang Tran, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 3102 E. Highland Avenue, Medical Staff Office, Patton, CA 92369 Phone: 909-425-7679 Fax: 909-425-6635 | |
Rainer Guerra Bansuan, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 3102 E Highland Ave, Patton, CA 92369 Phone: 909-815-0965 | |
Dr. Robert Lin, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3102 E Highland Ave, Patton Medical Services, Patton, CA 92369 Phone: 909-425-7000 | |
Dr. Mohamed Amr Hafez, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 3102 E. Highland Avenue, Medical Staff Office, Patton, CA 92369 Phone: 909-425-7679 Fax: 909-425-6635 |