| Shu Dong, NP | |
|
12359 Malki Rd, Banning, CA 92220-6974 | |
| (951) 922-2058 | |
| (888) 551-2116 |
| Full Name | Shu Dong |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 15 Years |
| Location | 12359 Malki Rd, Banning, 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 |
|---|---|---|---|
| 1376842005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 1117425 (Texas) | Secondary |
| 363L00000X | Nurse Practitioner | 20192 (California) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Careathome Medical Practice | 4183035876 | 66 |
| Careathome Medical Practice Ma Pc | 4385049162 | 23 |
| Entity Name | Urban Family Practice Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164594099 PECOS PAC ID: 7517935059 Enrollment ID: O20040922000333 |
| Entity Name | Five Star Medical Office Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760731459 PECOS PAC ID: 8820248016 Enrollment ID: O20121024000554 |
| Entity Name | Careathome Medical Practice |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891319810 PECOS PAC ID: 4183035876 Enrollment ID: O20201202000517 |
| Mailing Address | Practice Location Address |
|---|---|
| Shu Dong, NP 12359 Malki Rd, Banning, CA 92220-6974 Ph: (951) 922-2058 | Shu Dong, NP 12359 Malki Rd, Banning, CA 92220-6974 Ph: (951) 922-2058 |
Mrs. Marie Antoinette Tanare Lucco, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 264 N Highland Springs Ave, Banning, CA 92220 Phone: 760-413-3755 | |
Kevin Simmons, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 264 N Highland Springs Ave Ste 1b, Banning, CA 92220 Phone: 951-769-7191 | |
Amy Barber, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 161 W Ramsey St Bldg 2, Banning, CA 92220 Phone: 760-202-0686 | |
Monemala Philavong-danh, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 330 W Ramsey St, Banning, CA 92220 Phone: 951-849-1950 | |
Laura A Macmanus, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 264 N Highland Springs Ave, Banning, CA 92220 Phone: 951-845-6993 | |
Susan Jane Sheedy, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5957 W Ramsey St, Banning, CA 92220 Phone: 951-846-0313 | |
Kelly Marie Stormes, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6109 W Ramsey St, Banning, CA 92220 Phone: 951-845-0313 |