Organization
GAUTAMI AGASTYA, MD., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAUTAMI AGASTYA MD (PRESIDENT)
(209) 833-7555
Entity
Organization
Contact information
Practice address
652 W 11TH ST, SUITE 137, TRACY, CA 95376-3869
(209) 833-7555
(209) 833-7518
Mailing address
652 W 11TH ST, SUITE 137, TRACY, CA 95376-3869
(209) 833-7555
(209) 833-7518
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
C51385
CA
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
A85126
CA
Other
Enumeration date
02/21/2008
Last updated
02/13/2013
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