| Mr Dean Matthew Kelaita, MD | |
|
702 Mountain Ranch Rd., San Andreas, CA 95249 | |
| (209) 754-0870 | |
| (209) 754-0878 |
| Full Name | Mr Dean Matthew Kelaita |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 32 Years |
| Location | 702 Mountain Ranch Rd., San Andreas, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750310496 | NPI | - | NPPES |
| 00G800690 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G80069 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Iron Point Home Health Care Inc | Folsom, CA | Home health agency |
| Home Health Of California Inc | Stockton, CA | Home health agency |
| United Home Care Of Northern California | Jackson, CA | Home health agency |
| Mark Twain Medical Center | San andreas, CA | Hospital |
| Sutter Amador Hospital | Jackson, CA | Hospital |
| Adventist Health Sonora | Sonora, CA | Hospital |
| Avalon Health Care - San Andreas | San andreas, CA | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mark Twain Medical Center | 8820073711 | 17 |
| Entity Name | Sonora Community Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821089749 PECOS PAC ID: 4284538505 Enrollment ID: O20050411001282 |
| 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 |
| Entity Name | Dean M Kelaita M D Medical |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548930803 PECOS PAC ID: 5395133391 Enrollment ID: O20211025001239 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Dean Matthew Kelaita, MD P.o. Box 636, San Andreas, CA 95249 Ph: (209) 754-0870 | Mr Dean Matthew Kelaita, MD 702 Mountain Ranch Rd., San Andreas, CA 95249 Ph: (209) 754-0870 |
Matthew Joshua King-lung Kor, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 702 Mountain Ranch Rd, San Andreas, CA 95249 Phone: 092-754-4564 Fax: 209-942-3462 | |
Dr. Michael Dennis Kifune, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1333 Highway 49, San Andreas, CA 95249 Phone: 209-755-1400 Fax: 209-755-1430 | |
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 | |
Mrs. Sarah Margaret Grimes, MD 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 |