| Long Thao, M.d. Inc. | |
|
700 W Olive Ave Suite A Merced CA 95348-2435 | |
| (209) 384-8426 | |
| (209) 384-8015 |
| Full Name | Long Thao, M.d. Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 700 W Olive Ave, Merced, California |
| Authorized Official Name and Position | Seng Thao (MANAGER) |
| Authorized Official Contact | 2093848426 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Long Thao, M.d. Inc. 700 W Olive Ave Suite A Merced CA 95348-2435 Ph: (209) 384-8426 | Long Thao, M.d. Inc. 700 W Olive Ave Suite A Merced CA 95348-2435 Ph: (209) 384-8426 |
| NPI Number | 1568705481 |
|---|---|
| Provider Enumeration Date | 03/28/2013 |
| Last Update Date | 03/28/2013 |
| Medicare PECOS PAC ID | 4981844545 |
|---|---|
| Medicare Enrollment ID | O20130703000175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568705481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G66867 (California) | Primary |
| Provider Name | Long Thao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245341445 PECOS PAC ID: 9234323940 Enrollment ID: I20101027000071 |
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