| Praveena Sarma Md Medical Corp | |
|
652 W 11th St Suite 129 Tracy CA 95376-3869 | |
| (209) 833-0998 | |
| (209) 832-3006 |
| Full Name | Praveena Sarma Md Medical Corp |
|---|---|
| Speciality | Internal Medicine |
| Location | 652 W 11th St, Tracy, California |
| Authorized Official Name and Position | Praveena N Sarma (PRESIDENT) |
| Authorized Official Contact | 2098330998 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Praveena Sarma Md Medical Corp 652 W 11th St Suite 129 Tracy CA 95376-3869 Ph: (209) 833-0998 | Praveena Sarma Md Medical Corp 652 W 11th St Suite 129 Tracy CA 95376-3869 Ph: (209) 833-0998 |
| NPI Number | 1285716357 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 10/30/2014 |
| Medicare PECOS PAC ID | 7810118254 |
|---|---|
| Medicare Enrollment ID | O20141028000873 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285716357 | NPI | - | NPPES |
| 00A615331 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | A61533 (California) | Primary |
| Provider Name | Praveena N Sarma |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1194793182 PECOS PAC ID: 6608919535 Enrollment ID: I20100201000538 |
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