| Mina Raju DO Inc | |
|
5400 W Hillsdale Ave Visalia CA 93291-8222 | |
| (559) 302-7927 | |
| (559) 741-9938 |
| Full Name | Mina Raju DO Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5400 W Hillsdale Ave, Visalia, California |
| Authorized Official Name and Position | Mina Raju (CEO) |
| Authorized Official Contact | 5593027927 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mina Raju DO Inc Po Box 2744 Visalia CA 93279-2744 Ph: (559) 302-7927 | Mina Raju DO Inc 5400 W Hillsdale Ave Visalia CA 93291-8222 Ph: (559) 302-7927 |
| NPI Number | 1942658034 |
|---|---|
| Provider Enumeration Date | 05/30/2016 |
| Last Update Date | 05/30/2016 |
| Medicare PECOS PAC ID | 6800188574 |
|---|---|
| Medicare Enrollment ID | O20160718000761 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942658034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 20A9970 (California) | Primary |
| Provider Name | Mina Raju |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1588600068 PECOS PAC ID: 0345244687 Enrollment ID: I20071228000494 |
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