| San Joaquin Prime Care Medical Group Inc | |
|
330 E Pine St Exeter CA 93221-1838 | |
| (559) 592-2134 | |
| (559) 592-5017 |
| Full Name | San Joaquin Prime Care Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 330 E Pine St, Exeter, California |
| Authorized Official Name and Position | Rita Nye (BILLING SUPERVISOR) |
| Authorized Official Contact | 5597831181 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Joaquin Prime Care Medical Group Inc 330 E Pine St Exeter CA 93221-1838 Ph: (559) 592-2134 | San Joaquin Prime Care Medical Group Inc 330 E Pine St Exeter CA 93221-1838 Ph: (559) 592-2134 |
| NPI Number | 1265580500 |
|---|---|
| Provider Enumeration Date | 01/05/2007 |
| Last Update Date | 04/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265580500 | NPI | - | NPPES |
| GR0084780 | Medicaid | CA | |
| RHM53822F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A43893 (California) | Primary |
Omni Family Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1110 W. Visalia Rd, #102, Exeter, CA 93221 Phone: 661-459-1900 Fax: 661-746-9197 | |
Shyam Bhaskar Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 E Maple St, Exeter, CA 93221 Phone: 559-592-6039 Fax: 559-635-7106 | |
Rulon Douglas Owen Do Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 244 N Kaweah Ave, Exeter, CA 93221 Phone: 559-592-3889 |