| Eastern Medical Center | |
|
2930 Eastern Ave Sacramento CA 95821-4210 | |
| (916) 972-8966 | |
| (916) 972-8916 |
| Full Name | Eastern Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 2930 Eastern Ave, Sacramento, California |
| Authorized Official Name and Position | Li Li (CEO) |
| Authorized Official Contact | 9169728966 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Medical Center 2930 Eastern Ave Sacramento CA 95821-4210 Ph: (916) 972-8966 | Eastern Medical Center 2930 Eastern Ave Sacramento CA 95821-4210 Ph: (916) 972-8966 |
| NPI Number | 1598093262 |
|---|---|
| Provider Enumeration Date | 11/18/2009 |
| Last Update Date | 12/23/2009 |
| Medicare PECOS PAC ID | 5496890626 |
|---|---|
| Medicare Enrollment ID | O20100226000607 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598093262 | NPI | - | NPPES |
| 1134230220 | Other | CA | NPI |
| 1912973520 | Other | CA | NPI |
| 1710959523 | Other | CA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A65618 (California) | Primary |
| 207R00000X | Internal Medicine | A83360 (California) | Secondary |
| 208D00000X | General Practice | A73749 (California) | Secondary |
| Provider Name | Kuldip S Gill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295882769 PECOS PAC ID: 7719970821 Enrollment ID: I20040407001103 |
| Provider Name | Li Li |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1710959523 PECOS PAC ID: 0648212209 Enrollment ID: I20050524001424 |
| Provider Name | Charles C Shang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104805902 PECOS PAC ID: 0840239497 Enrollment ID: I20150916003083 |
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