Organization
TRACY ANESTHESIA & PAIN MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRASAD PERUMBETI V MD (PRESIDENT)
(209) 835-1500
Entity
Organization
Contact information
Practice address
1420 N TRACY BLVD, TRACY, CA 95376-3451
(209) 835-1500
Mailing address
PO BOX 7156, STOCKTON, CA 95267-0156
(209) 467-6866
(209) 467-6865
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
12/27/2006
Last updated
08/22/2020
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