| Robert Tracy DO, Inc | |
|
3056 Fletcher Dr Los Angeles CA 90065-2207 | |
| (323) 256-2231 | |
| (323) 892-2571 |
| Full Name | Robert Tracy DO, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 3056 Fletcher Dr, Los Angeles, California |
| Authorized Official Name and Position | Robert a Tracy (OWNER) |
| Authorized Official Contact | 3232562231 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert Tracy DO, Inc 3056 Fletcher Dr Los Angeles CA 90065-2207 Ph: (323) 256-2231 | Robert Tracy DO, Inc 3056 Fletcher Dr Los Angeles CA 90065-2207 Ph: (323) 256-2231 |
| NPI Number | 1083005474 |
|---|---|
| Provider Enumeration Date | 02/06/2015 |
| Last Update Date | 09/04/2024 |
| Certification Date | 09/04/2024 |
| Medicare PECOS PAC ID | 9638483001 |
|---|---|
| Medicare Enrollment ID | O20150729007922 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083005474 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Ron a Birnbaum |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1942412291 PECOS PAC ID: 5698942415 Enrollment ID: I20120119000454 |
| Provider Name | Robert Tracy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316219058 PECOS PAC ID: 0244457380 Enrollment ID: I20140813000714 |
| Provider Name | Martha G Morris |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578800827 PECOS PAC ID: 2668789645 Enrollment ID: I20150923003408 |
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