| Vijaya K. Tangella Md, Inc | |
|
750 W Olive Ave Suite 104 Merced CA 95348-2436 | |
| (209) 384-2704 | |
| Not Available |
| Full Name | Vijaya K. Tangella Md, Inc |
|---|---|
| Speciality | Anesthesiology |
| Location | 750 W Olive Ave, Merced, California |
| Authorized Official Name and Position | Vijaya K Tangella (OWNER) |
| Authorized Official Contact | 2093842704 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vijaya K. Tangella Md, Inc 750 W Olive Ave Suite 104 Merced CA 95348-2436 Ph: (209) 384-2704 | Vijaya K. Tangella Md, Inc 750 W Olive Ave Suite 104 Merced CA 95348-2436 Ph: (209) 384-2704 |
| NPI Number | 1023256153 |
|---|---|
| Provider Enumeration Date | 01/27/2009 |
| Last Update Date | 12/26/2023 |
| Medicare PECOS PAC ID | 7810930807 |
|---|---|
| Medicare Enrollment ID | O20050610000185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023256153 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A045065 (California) | Secondary |
| 207L00000X | Anesthesiology | A045065 (California) | Primary |
| Provider Name | Vijaya K Tangella |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902024623 PECOS PAC ID: 7214093434 Enrollment ID: I20090312000502 |
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