| Geriguidemd Llc | |
|
19565 Aster Ln Bend OR 97702-2111 | |
| (801) 718-3808 | |
| Not Available |
| Full Name | Geriguidemd Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 19565 Aster Ln, Bend, Oregon |
| Authorized Official Name and Position | Sonal Sonia Thakur (CMD/GERIATRICS) |
| Authorized Official Contact | 8017183808 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Geriguidemd Llc 19565 Aster Ln Bend OR 97702-2111 Ph: (801) 718-3808 | Geriguidemd Llc 19565 Aster Ln Bend OR 97702-2111 Ph: (801) 718-3808 |
| NPI Number | 1538670732 |
|---|---|
| Provider Enumeration Date | 10/16/2017 |
| Last Update Date | 10/16/2017 |
| Medicare PECOS PAC ID | 0941569651 |
|---|---|
| Medicare Enrollment ID | O20180125000563 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538670732 | NPI | - | NPPES |
| 000000000 | Other | NO INSURERS YET |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | MD152920 (Oregon) | Primary |
| Provider Name | Sonal S Thakur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831353226 PECOS PAC ID: 1153481965 Enrollment ID: I20110408000685 |
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