| Sam Peter Kokoris, MD | |
|
1530 Bessie Ave, Ste 108, Tracy, CA 95376-3080 | |
| (209) 342-2300 | |
| (209) 524-4240 |
| Full Name | Sam Peter Kokoris |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 1530 Bessie Ave, Tracy, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578553335 | NPI | - | NPPES |
| 00G815190 | Other | CA | BLUE SHIELD |
| 00G815190 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | G81519 (California) | Primary |
| Entity Name | Bay Imaging Consultants Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356597637 PECOS PAC ID: 9537069125 Enrollment ID: O20040110000189 |
| Entity Name | County Of Santa Clara |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699885079 PECOS PAC ID: 1254244973 Enrollment ID: O20040113000784 |
| Entity Name | County Of San Joaquin |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801830583 PECOS PAC ID: 6002703436 Enrollment ID: O20040301001287 |
| Entity Name | San Joaquin Faculty Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225063761 PECOS PAC ID: 4082631395 Enrollment ID: O20051026000742 |
| Entity Name | Golden Gate Radiology Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073654232 PECOS PAC ID: 4880792779 Enrollment ID: O20070530000364 |
| Mailing Address | Practice Location Address |
|---|---|
| Sam Peter Kokoris, MD 4301 Northstar Way, Modesto, CA 95356-9262 Ph: (209) 342-2300 | Sam Peter Kokoris, MD 1530 Bessie Ave, Ste 108, Tracy, CA 95376-3080 Ph: (209) 342-2300 |
Richard Michael Porzio, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1530 Bessie Ave, Ste 108, Tracy, CA 95376 Phone: 209-342-2300 Fax: 209-524-4240 | |
Mario P Sattah, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1530 Bessie Ave, Suite 108, Tracy, CA 95376 Phone: 209-833-2393 Fax: 209-833-2399 | |
Keith Kwok, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1530 North Bessie Avenue, Suite 108, Tracy, CA 95376 Phone: 209-833-2393 | |
Chull Sung Song, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 1530 Bessie Ave, Ste 108, Tracy, CA 95376 Phone: 209-342-2300 Fax: 209-524-4240 | |
Garth Howland Harley Jr., MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1530 Bessie Ave, Suite 108, Tracy, CA 95376 Phone: 209-342-2300 Fax: 209-524-4240 | |
Kyle Kai Yu, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1530 Bessie Ave, Ste 108, Tracy, CA 95376 Phone: 209-342-2300 Fax: 209-524-4240 |