| Manmeet Johal, FNP | |
|
489 5th St, Gustine, CA 95322-1514 | |
| (209) 854-3728 | |
| Not Available |
| Full Name | Manmeet Johal |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 489 5th St, Gustine, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225371925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 22795 (California) | Primary |
| 363LP2300X | Nurse Practitioner - Primary Care | 22795 (California) | Secondary |
| 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 |
| Entity Name | Community Health Centers Of America |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891207684 PECOS PAC ID: 3476813460 Enrollment ID: O20180213001169 |
| Mailing Address | Practice Location Address |
|---|---|
| Manmeet Johal, FNP 2662 Remington Way, Tracy, CA 95377-6695 Ph: (209) 833-7440 | Manmeet Johal, FNP 489 5th St, Gustine, CA 95322-1514 Ph: (209) 854-3728 |
Mrs. Lisa Brush, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 489 5th St, Gustine, CA 95322 Phone: 209-854-3728 | |
Sandra J. Haar, F.N.P Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 554 5th St, Gustine, CA 95322 Phone: 209-854-3854 Fax: 209-854-6758 | |
Mr. Jack Hurd Clendenin, NURSE PRACTITIONER Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 581 4th Ave, Gustine, CA 95322 Phone: 209-854-1120 Fax: 209-854-1118 | |
Saudia Fatima Whitaker, AGNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 489 5th St, Gustine, CA 95322 Phone: 209-854-3728 |