Unknown Individual – Internal Medicine Physician, NPI 1619962545
Internal Medicine Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
665, New York Ranch Road, Jackson Rancheria Casino Resort, Jackson, Amador County, California, 95642, United States
STE 4
JACKSON, CA 956429331
Phone: (209) 223-4700
Fax: (209) 231-3420
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 95642)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INTERNAL MEDICINE | CA | 17003 | Destruction of 2-14 skin growths | 77 | 13 |
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