| Ronald J Botelho, MD | |
|
925 Bevins Ct, Lakeport, CA 95453-9754 | |
| (707) 263-8382 | |
| (707) 263-1909 |
| Full Name | Ronald J Botelho |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Experience | 44 Years |
| Location | 925 Bevins Ct, Lakeport, California |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235199373 | NPI | - | NPPES |
| 100501809 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 10484 (Nevada) | Secondary |
| 207LP2900X | Anesthesiology - Pain Medicine | G53308 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Adventist Health Clearlake | Clearlake, CA | Hospital |
| Sutter Lakeside Hospital | Lakeport, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lake County Tribal Health Consortium Inc | 8729975545 | 37 |
| Entity Name | Lake County Tribal Health Consortium Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881697381 PECOS PAC ID: 8729975545 Enrollment ID: O20040304000323 |
| Entity Name | Lyons Huber Management |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891370854 PECOS PAC ID: 4789093741 Enrollment ID: O20210504002949 |
| Mailing Address | Practice Location Address |
|---|---|
| Ronald J Botelho, MD Po Box 1950, Lakeport, CA 95453-1950 Ph: (707) 263-8382 | Ronald J Botelho, MD 925 Bevins Ct, Lakeport, CA 95453-9754 Ph: (707) 263-8382 |
Dr. Frederick L Johnson, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 987 Parallel Dr, Lakeport, CA 95453 Phone: 707-263-7428 Fax: 707-263-7425 | |
Dr. Kerry John Hollenbeck, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 5176 Hill Rd E, Lakeport, CA 95453 Phone: 707-262-5000 | |
Helen Vernetta Johnson, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 987 Parallel Dr, Suite 104, Lakeport, CA 95453 Phone: 707-263-7428 Fax: 707-263-7425 | |
Harrison B Edgley Jr., M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 5176 Hill Rd E, Lakeport, CA 95453 Phone: 888-453-6625 Fax: 818-550-0909 | |
Darcene Melaac Munir, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 5176 Hill Rd E, Lakeport, CA 95453 Phone: 818-550-0900 Fax: 303-953-8260 |