| Praveen Kumar Mambalam, MD | |
|
21616 76th Ave W, Ste 102, Edmonds, WA 98026-7512 | |
| (425) 774-1538 | |
| (425) 744-1527 |
| Full Name | Praveen Kumar Mambalam |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Experience | 21 Years |
| Location | 21616 76th Ave W, Edmonds, Washington |
| 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 |
|---|---|---|---|
| 1790942886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207LP2900X | Anesthesiology - Pain Medicine | MD 00049423 (Washington) | Primary |
| Entity Name | Robert G R Lang Md Inc Ps |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447329412 PECOS PAC ID: 4981594538 Enrollment ID: O20040317000881 |
| Entity Name | Washington Center For Pain Management Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194381905 PECOS PAC ID: 0143329169 Enrollment ID: O20070615000367 |
| Entity Name | Pain Care Physicians Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144779232 PECOS PAC ID: 9537448931 Enrollment ID: O20161107001926 |
| Entity Name | Pain Care Physicians Pllc |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1144779232 PECOS PAC ID: 9537448931 Enrollment ID: O20200424000295 |
| Entity Name | Washington Pain And Spine Specialists Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992486906 PECOS PAC ID: 7315381639 Enrollment ID: O20240214003694 |
| Mailing Address | Practice Location Address |
|---|---|
| Praveen Kumar Mambalam, MD Po Box 827, Bellevue, WA 98009-0827 Ph: (425) 774-1538 | Praveen Kumar Mambalam, MD 21616 76th Ave W, Ste 102, Edmonds, WA 98026-7512 Ph: (425) 774-1538 |
Babu Rajendran, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 21601 76th Ave W, Edmonds, WA 98026 Phone: 425-640-4000 Fax: 206-672-0211 | |
Emerly Tran Hoang Luong, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 21601 76th Ave W, Edmonds, WA 98026 Phone: 425-640-4000 | |
Carolyn G. Miller, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 21601 76th Ave W, Edmonds, WA 98026 Phone: 425-640-4000 Fax: 206-672-0211 | |
Brendan Rhodes O'donnell, Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 21616 76th W Ave, Suite 209, Edmonds, WA 98026 Phone: 425-774-5163 Fax: 425-744-1705 | |
David Inadomi, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 21601 76th Ave W, Edmonds, WA 98026 Phone: 425-640-4000 Fax: 206-672-0211 | |
Patrick Cheng-ann Lee, Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 21601 76th Ave W, Edmonds, WA 98026 Phone: 425-640-4000 | |
Ms. Jessica Kristine Lee, Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 21601 76th Ave W, Edmonds, WA 98026 Phone: 425-640-4000 |