| Pradeepa Selvakumar Md Inc, A California Professional Corporation | |
|
101 S San Mateo Dr Ste 102 San Mateo CA 94401-3840 | |
| (650) 435-8211 | |
| (844) 965-9436 |
| Full Name | Pradeepa Selvakumar Md Inc, A California Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 101 S San Mateo Dr Ste 102, San Mateo, California |
| Authorized Official Name and Position | Pradeepa Selvakumar (OWNER) |
| Authorized Official Contact | 6504358211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pradeepa Selvakumar Md Inc, A California Professional Corporation 2889 Baze Rd San Mateo CA 94403-3436 Ph: (415) 778-0813 | Pradeepa Selvakumar Md Inc, A California Professional Corporation 101 S San Mateo Dr Ste 102 San Mateo CA 94401-3840 Ph: (650) 435-8211 |
| NPI Number | 1013472950 |
|---|---|
| Provider Enumeration Date | 02/05/2019 |
| Last Update Date | 02/05/2019 |
| Medicare PECOS PAC ID | 0143556670 |
|---|---|
| Medicare Enrollment ID | O20190722003026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013472950 | NPI | - | NPPES |
| 1912090226 | Other | CA | OTHER INSURANCES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Pradeepa Selvakumar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912090226 PECOS PAC ID: 0446266548 Enrollment ID: I20060227000717 |
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