| Lily Enayati Md Inc | |
|
1 Baywood Ave Ste 10 San Mateo CA 94402-1537 | |
| (650) 342-2974 | |
| (650) 347-5404 |
| Full Name | Lily Enayati Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 Baywood Ave Ste 10, San Mateo, California |
| Authorized Official Name and Position | Michelle Pfeffer (PRACTICE MANAGER) |
| Authorized Official Contact | 6503422974 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lily Enayati Md Inc 1 Baywood Ave Ste 10 San Mateo CA 94402-1537 Ph: (650) 342-2974 | Lily Enayati Md Inc 1 Baywood Ave Ste 10 San Mateo CA 94402-1537 Ph: (650) 342-2974 |
| NPI Number | 1205592946 |
|---|---|
| Provider Enumeration Date | 11/16/2021 |
| Last Update Date | 11/16/2021 |
| Medicare PECOS PAC ID | 6305237132 |
|---|---|
| Medicare Enrollment ID | O20220105000325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205592946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Lily Naveed Enayati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447322847 PECOS PAC ID: 8729028386 Enrollment ID: I20050503001377 |
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