| Om Sood Md A Professional Medical Corporation | |
|
12998 Hesperia Rd Suite 101 Victorville CA 92395-8316 | |
| (760) 955-2828 | |
| (760) 955-2488 |
| Full Name | Om Sood Md A Professional Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 12998 Hesperia Rd, Victorville, California |
| Authorized Official Name and Position | Om Paricash Sood (PRESIDENT) |
| Authorized Official Contact | 7609552828 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Om Sood Md A Professional Medical Corporation 12998 Hesperia Rd Suite 101 Victorville CA 92395-8316 Ph: (760) 955-2828 | Om Sood Md A Professional Medical Corporation 12998 Hesperia Rd Suite 101 Victorville CA 92395-8316 Ph: (760) 955-2828 |
| NPI Number | 1114091857 |
|---|---|
| Provider Enumeration Date | 11/17/2006 |
| Last Update Date | 08/06/2014 |
| Medicare PECOS PAC ID | 7517913858 |
|---|---|
| Medicare Enrollment ID | O20050329001357 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114091857 | NPI | - | NPPES |
| GR0101680 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Om P Sood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023182763 PECOS PAC ID: 0446143051 Enrollment ID: I20040206000432 |
| Provider Name | Archna Sood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003980756 PECOS PAC ID: 5698721991 Enrollment ID: I20050330000320 |
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