| Keely Reed Tietjen, PA-C | |
|
2070 Clinton Ave, Alameda, CA 94501-4399 | |
| (510) 864-1800 | |
| Not Available |
| Full Name | Keely Reed Tietjen |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 8 Years |
| Location | 2070 Clinton Ave, Alameda, California |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639738040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA56700 (California) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Permanente Medical Group Inc | 8921910225 | 10928 |
| Entity Name | Permanente Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
| Mailing Address | Practice Location Address |
|---|---|
| Keely Reed Tietjen, PA-C 6 Diablo Cir, Lafayette, CA 94549-3316 Ph: Not Available | Keely Reed Tietjen, PA-C 2070 Clinton Ave, Alameda, CA 94501-4399 Ph: (510) 864-1800 |
Daniel Thai, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 815 Atlantic Ave, Alameda, CA 94501 Phone: 510-535-7363 |
Maxwell Kaczmarek, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1 Eagle Rd, Alameda, CA 94501 Phone: 510-437-3582 |
Meridith A Palo, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1 Eagle Rd, Alameda, CA 94501 Phone: 510-437-3584 |
Seng Vang, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 455 Buena Vista Ave Apt 302, Alameda, CA 94501 Phone: 510-809-5678 |
Christine Harper Moscati, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2421 Encinal Ave Ste A, Alameda, CA 94501 Phone: 510-995-8200 |
Ms. Catherine B. Egelhoff, PAC Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2433 Central Ave., Alameda, CA 94501 Phone: 510-521-2300 Fax: 510-864-6879 |
Kimberlyn Taylor, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1005 Atlantic Ave, Alameda, CA 94501 Phone: 510-309-6549 Fax: 510-830-3318 |