| Mesa West Medical Inc | |
|
8327 Brimhall Road Bldg 700 Suite 704 Bakersfield CA 93312 | |
| (661) 617-6750 | |
| (661) 617-6760 |
| Full Name | Mesa West Medical Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8327 Brimhall Road Bldg 700, Bakersfield, California |
| Authorized Official Name and Position | William Edward Gilli (OWNER) |
| Authorized Official Contact | 6616176750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mesa West Medical Inc 8327 Brimhall Road Bldg 700 Suite 704 Bakersfield CA 93312-0000 Ph: (661) 617-6750 | Mesa West Medical Inc 8327 Brimhall Road Bldg 700 Suite 704 Bakersfield CA 93312 Ph: (661) 617-6750 |
| NPI Number | 1821294596 |
|---|---|
| Provider Enumeration Date | 06/21/2007 |
| Last Update Date | 02/17/2014 |
| Medicare PECOS PAC ID | 5991891053 |
|---|---|
| Medicare Enrollment ID | O20071019000589 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821294596 | NPI | - | NPPES |
| GR0057501 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G53033 (California) | Primary |
| Provider Name | William Edward Gilli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447257100 PECOS PAC ID: 2264528322 Enrollment ID: I20071019000596 |
| Provider Name | Tracy Simonsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023195005 PECOS PAC ID: 6901024801 Enrollment ID: I20140905000527 |
| Provider Name | Kevin F Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316023385 PECOS PAC ID: 2769791920 Enrollment ID: I20151029000569 |
| Provider Name | Sarah Lee Dowda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003514324 PECOS PAC ID: 6305211376 Enrollment ID: I20230404002041 |
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