| Gettysburg Medical Clinic, Inc. | |
|
3128 E Gettysburg Ave Fresno CA 93726-0400 | |
| (559) 244-6360 | |
| (559) 229-5940 |
| Full Name | Gettysburg Medical Clinic, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 3128 E Gettysburg Ave, Fresno, California |
| Authorized Official Name and Position | Grace Wee Lim (PRESIDENT) |
| Authorized Official Contact | 5592446360 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gettysburg Medical Clinic, Inc. 3128 E Gettysburg Ave Fresno CA 93726-0400 Ph: (559) 244-6360 | Gettysburg Medical Clinic, Inc. 3128 E Gettysburg Ave Fresno CA 93726-0400 Ph: (559) 244-6360 |
| NPI Number | 1063519858 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5991957805 |
|---|---|
| Medicare Enrollment ID | O20121128000353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063519858 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Laura E Dykes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205910510 PECOS PAC ID: 4183806102 Enrollment ID: I20110314000183 |
| Provider Name | Grace Wee Lim |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1437256211 PECOS PAC ID: 6800048711 Enrollment ID: I20121129000161 |
| Provider Name | Ellen R Gibbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316946874 PECOS PAC ID: 1759416183 Enrollment ID: I20210414000396 |
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