| Tracy Medical Group | |
|
530 W Eaton Ave Ste K Tracy CA 95376 | |
| (209) 835-4232 | |
| (209) 835-3246 |
| Full Name | Tracy Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 530 W Eaton Ave Ste K, Tracy, California |
| Authorized Official Name and Position | Kriss Milts (OFFICE MANAGER) |
| Authorized Official Contact | 2098354232 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tracy Medical Group 530 W Eaton Ave Ste K Tracy CA 95376 Ph: (209) 835-4232 | Tracy Medical Group 530 W Eaton Ave Ste K Tracy CA 95376 Ph: (209) 835-4232 |
| NPI Number | 1639135510 |
|---|---|
| Provider Enumeration Date | 04/21/2006 |
| Last Update Date | 02/05/2010 |
| Medicare PECOS PAC ID | 2961459466 |
|---|---|
| Medicare Enrollment ID | O20050406001055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639135510 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A40558 (California) | Primary |
| 207R00000X | Internal Medicine | A53793 (California) | Secondary |
| Provider Name | Harpreet Grewal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700842697 PECOS PAC ID: 8123091907 Enrollment ID: I20110207000122 |
| Provider Name | Puneet Grewal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750347639 PECOS PAC ID: 6608056866 Enrollment ID: I20110207000225 |
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