| Daniel E Welburn, PA-C | |
|
833 W Whittier Blvd, Montebello, CA 90640-4735 | |
| (323) 712-4811 | |
| (323) 544-6488 |
| Full Name | Daniel E Welburn |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 833 W Whittier Blvd, Montebello, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578704623 | NPI | - | NPPES |
| PA20234 | Other | CA | CA LICENSE - PHYSICIAN ASSISTANT |
| RN527054 | Other | CA | CA LICENSE - REGISTERED NURSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | PA20234 (California) | Secondary |
| 363A00000X | Physician Assistant | PA20234 (California) | Primary |
| Entity Name | Permanente Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
| Entity Name | R. Ruiz MD a Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245261023 PECOS PAC ID: 4688562432 Enrollment ID: O20040304001085 |
| Entity Name | R. Ruiz, M.D., a Medical Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578599809 PECOS PAC ID: 4981592391 Enrollment ID: O20040308000956 |
| Entity Name | Ruben Ruiz M D a Medical Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043241821 PECOS PAC ID: 0648168062 Enrollment ID: O20040308000994 |
| Mailing Address | Practice Location Address |
|---|---|
| Daniel E Welburn, PA-C 833 W Whittier Blvd, Montebello, CA 90640-4735 Ph: (323) 712-4811 | Daniel E Welburn, PA-C 833 W Whittier Blvd, Montebello, CA 90640-4735 Ph: (323) 712-4811 |