| Sprinter Medical West Pc | |
|
4600 Bohannon Dr Ste 100 Menlo Park CA 94025-1037 | |
| (209) 677-7468 | |
| Not Available |
| Full Name | Sprinter Medical West Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 4600 Bohannon Dr Ste 100, Menlo Park, California |
| Authorized Official Name and Position | Arun Villivalam (CEO) |
| Authorized Official Contact | 2096777468 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sprinter Medical West Pc 2375 Montpelier Dr Ste 20 San Jose CA 95116-1627 Ph: (209) 677-7468 | Sprinter Medical West Pc 4600 Bohannon Dr Ste 100 Menlo Park CA 94025-1037 Ph: (209) 677-7468 |
| NPI Number | 1790368702 |
|---|---|
| Provider Enumeration Date | 04/28/2021 |
| Last Update Date | 04/12/2024 |
| Medicare PECOS PAC ID | 1951799527 |
|---|---|
| Medicare Enrollment ID | O20211101002241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790368702 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Arun Villivalam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639355944 PECOS PAC ID: 3971558727 Enrollment ID: I20131017000361 |
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