| Raoul B Del Mar, MD | |
|
6508 Lonetree Blvd, Suite 103, Rocklin, CA 95765-5874 | |
| (916) 771-5533 | |
| (916) 771-5453 |
| Full Name | Raoul B Del Mar |
|---|---|
| Gender | Male |
| Speciality | Pediatrics - Adolescent Medicine |
| Location | 6508 Lonetree Blvd, Rocklin, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578507679 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | A89166 (California) | Secondary |
| 2080A0000X | Pediatrics - Adolescent Medicine | A89166 (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 |
| Mailing Address | Practice Location Address |
|---|---|
| Raoul B Del Mar, MD 9380 Courtney Way, Roseville, CA 95747-9147 Ph: (916) 218-8808 | Raoul B Del Mar, MD 6508 Lonetree Blvd, Suite 103, Rocklin, CA 95765-5874 Ph: (916) 771-5533 |
Thomas Stafford, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 6805 Five Star Blvd Ste 100, Rocklin, CA 95677 Phone: 916-624-3500 Fax: 916-624-3351 | |
Benjamin Fernandez Valdez, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5440 Park Dr, Ste 104, Rocklin, CA 95765 Phone: 916-677-8570 Fax: 916-677-8575 |