| Zodiac Medical Llc | |
|
3985 Steve Reynolds Blvd Ste K102 Norcross GA 30093-3099 | |
| (770) 277-6374 | |
| (800) 521-4382 |
| Full Name | Zodiac Medical Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3985 Steve Reynolds Blvd Ste K102, Norcross, Georgia |
| Authorized Official Name and Position | Dong Vien Dang (OWNER) |
| Authorized Official Contact | 3364203794 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Zodiac Medical Llc 3985 Steve Reynolds Blvd Ste K102 Norcross GA 30093-3099 Ph: (470) 221-2221 | Zodiac Medical Llc 3985 Steve Reynolds Blvd Ste K102 Norcross GA 30093-3099 Ph: (770) 277-6374 |
| NPI Number | 1083344576 |
|---|---|
| Provider Enumeration Date | 06/16/2022 |
| Last Update Date | 04/11/2023 |
| Medicare PECOS PAC ID | 8022492792 |
|---|---|
| Medicare Enrollment ID | O20220829003795 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083344576 | NPI | - | NPPES |
| Provider Name | Dong Vien Dang |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1275875551 PECOS PAC ID: 3375864192 Enrollment ID: I20210427001442 |
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