| Tyrone E Snipes D O Internal Medicine Primary Care Inc | |
|
3055 Alvarado St Ste 108 San Leandro CA 94577-5711 | |
| (510) 969-4253 | |
| Not Available |
| Full Name | Tyrone E Snipes D O Internal Medicine Primary Care Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3055 Alvarado St Ste 108, San Leandro, California |
| Authorized Official Name and Position | Tyrone E Snipes (CEO) |
| Authorized Official Contact | 5105049470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tyrone E Snipes D O Internal Medicine Primary Care Inc 3055 Alvarado St Ste 108 San Leandro CA 94577-5711 Ph: () - | Tyrone E Snipes D O Internal Medicine Primary Care Inc 3055 Alvarado St Ste 108 San Leandro CA 94577-5711 Ph: (510) 969-4253 |
| NPI Number | 1922619352 |
|---|---|
| Provider Enumeration Date | 08/10/2020 |
| Last Update Date | 06/16/2022 |
| Medicare PECOS PAC ID | 6103235650 |
|---|---|
| Medicare Enrollment ID | O20210512003180 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922619352 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Tyrone Emmanuel Snipes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861627457 PECOS PAC ID: 2466620554 Enrollment ID: I20110715000064 |
| Provider Name | Iziegbe Garuba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356879878 PECOS PAC ID: 7517236680 Enrollment ID: I20170705001322 |
| Provider Name | Sumaira A Cheema |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437677655 PECOS PAC ID: 5092080556 Enrollment ID: I20171009003161 |
| Provider Name | Myla Thong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982162970 PECOS PAC ID: 9931533973 Enrollment ID: I20200715000136 |
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