| Mr Radovan Anzulovic, PA | |
|
321 W Hobsonway, Blythe, CA 92225-1651 | |
| (760) 660-4790 | |
| (866) 554-1794 |
| Full Name | Mr Radovan Anzulovic |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 8 Years |
| Location | 321 W Hobsonway, Blythe, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518427129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA.0005629 (Colorado) | Secondary |
| 363A00000X | Physician Assistant | PA56599 (California) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hope Valley Health | 6507273711 | 4 |
| Entity Name | Santa Ynez River Physicians PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396210597 PECOS PAC ID: 7911241229 Enrollment ID: O20181127001998 |
| Entity Name | Hope Valley Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619552205 PECOS PAC ID: 6507273711 Enrollment ID: O20210405002112 |
| Entity Name | Em Alliance California APC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376305755 PECOS PAC ID: 1951749894 Enrollment ID: O20240410003580 |
| Entity Name | Blythe Oasis Community Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003788829 PECOS PAC ID: 8628553302 Enrollment ID: O20260331001552 |
| Entity Name | Buellterra Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831061472 PECOS PAC ID: 4284109687 Enrollment ID: O20260413002529 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Radovan Anzulovic, PA 179 N Elm St, Fruita, CO 81521-2208 Ph: (303) 667-3254 | Mr Radovan Anzulovic, PA 321 W Hobsonway, Blythe, CA 92225-1651 Ph: (760) 660-4790 |
Emmanuel Azubuike Nwisu, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 101 E Hobsonway Ste C, Blythe, CA 92225 Phone: 760-922-0446 |
Lynn Brunet, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 321 W Hobsonway, Suite C, Blythe, CA 92225 Phone: 760-344-9951 |
Samantha Ann Varghese, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 321 W Hobsonway Ste C, Blythe, CA 92225 Phone: 760-922-4981 |