| Meredith Dettmar, PA-C | |
|
10787 Laurel St, Rancho Cucamonga, CA 91730-3828 | |
| (099) 982-7741 | |
| Not Available |
| Full Name | Meredith Dettmar |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 10787 Laurel St, Rancho Cucamonga, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902275993 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 52882 (California) | Secondary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
| Entity Name | Chaparral Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477733624 PECOS PAC ID: 6800709403 Enrollment ID: O20031110000605 |
| Entity Name | Cep America - California |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548667843 PECOS PAC ID: 6103739131 Enrollment ID: O20040121000458 |
| Entity Name | John a Fagan MD Family Practice Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417130881 PECOS PAC ID: 4880764471 Enrollment ID: O20080609000673 |
| Mailing Address | Practice Location Address |
|---|---|
| Meredith Dettmar, PA-C 16705 Carob Ave, Chino Hills, CA 91709-6524 Ph: (909) 816-4256 | Meredith Dettmar, PA-C 10787 Laurel St, Rancho Cucamonga, CA 91730-3828 Ph: (099) 982-7741 |
Bryant Alex Lim, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 10565 Civic Center Dr, Rancho Cucamonga, CA 91730 Phone: 909-755-5533 |
Mrs. Antonia Lynn Rogers, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 7777 Milliken Ave Ste 110, Rancho Cucamonga, CA 91730 Phone: 909-948-7590 Fax: 909-948-7290 |
Mrs. Sarah Lynn Searles, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 8680 Monroe Ct Ste 200, Rancho Cucamonga, CA 91730 Phone: 909-987-0899 |
Haily Nicole Helton, PA Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 10837 Laurel St Ste 204, Rancho Cucamonga, CA 91730 Phone: 909-294-5358 |
Claire Rahoi, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 11398 Kenyon Way Ste J, Rancho Cucamonga, CA 91701 Phone: 909-727-3911 |
Kattya Isabel Low, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 9377 Haven Ave Ste 100, Rancho Cucamonga, CA 91730 Phone: 909-906-1505 |
Mr. Song Siameng Jann, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5131 Nellie Ct, Rancho Cucamonga, CA 91739 Phone: 213-841-4181 |