Gaurav Datta Md Inc - Medicare Primary Care in Elk Grove, CA

Gaurav Datta Md Inc is a medicare enrolled primary clinic (Internal Medicine) in Elk Grove, California. The current practice location for Gaurav Datta Md Inc is 7510 Fortaleza Ave, Elk Grove, California. For appointments, you can reach them via phone at (414) 336-8677. The mailing address for Gaurav Datta Md Inc is 7510 Fortaleza Ave, Elk Grove, California and phone number is (414) 336-8677.

Gaurav Datta Md Inc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1033735931. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (414) 336-8677.

Contact Information

Gaurav Datta Md Inc
7510 Fortaleza Ave
Elk Grove
CA 95757-1769
(414) 336-8677
(925) 954-6958

Primary Care Clinic Profile

Full NameGaurav Datta Md Inc
SpecialityInternal Medicine
Location7510 Fortaleza Ave, Elk Grove, California
Authorized Official Name and PositionGaurav Datta (OWNER)
Authorized Official Contact4143368677
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Gaurav Datta Md Inc
7510 Fortaleza Ave
Elk Grove
CA 95757-1769

Ph: (414) 336-8677
Gaurav Datta Md Inc
7510 Fortaleza Ave
Elk Grove
CA 95757-1769

Ph: (414) 336-8677

NPI Details:

NPI Number1033735931
Provider Enumeration Date06/17/2020
Last Update Date01/13/2023

Medicare PECOS Information:

Medicare PECOS PAC ID9234551920
Medicare Enrollment IDO20200625002405

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› Verified 9 days ago

Medical Identifiers

Medical identifiers for Gaurav Datta Md Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033735931NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine (* (Not Available))Primary
282N00000XGeneral Acute Care Hospital (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Gaurav Datta Md Inc acts as a billing entity for following providers:
Provider NameGaurav Datta
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1225184765
PECOS PAC ID: 7113093055
Enrollment ID: I20180822001727

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