| Pardeep Brar M.d., Inc. | |
|
803 Coffee Rd Suite #5 Modesto CA 95355-4227 | |
| (209) 484-9855 | |
| Not Available |
| Full Name | Pardeep Brar M.d., Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 803 Coffee Rd, Modesto, California |
| Authorized Official Name and Position | Pardeep Brar (OWNER) |
| Authorized Official Contact | 2094849855 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pardeep Brar M.d., Inc. Po Box 3346 Modesto CA 95353-3346 Ph: (209) 484-9855 | Pardeep Brar M.d., Inc. 803 Coffee Rd Suite #5 Modesto CA 95355-4227 Ph: (209) 484-9855 |
| NPI Number | 1992067631 |
|---|---|
| Provider Enumeration Date | 06/08/2012 |
| Last Update Date | 06/08/2012 |
| Medicare PECOS PAC ID | 4789848284 |
|---|---|
| Medicare Enrollment ID | O20120613000589 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992067631 | NPI | - | NPPES |
| EP663Z | Other | CA | MEDICARE INDIVIDUAL PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | C54142 (California) | Primary |
| Provider Name | Pardeep Brar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1538153713 PECOS PAC ID: 8123913126 Enrollment ID: I20110321000916 |
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