| Carrillo Medical Group Professional Corporation | |
|
1800 Sullivan Ave Rm 101 Daly City CA 94015-2227 | |
| (650) 994-0459 | |
| Not Available |
| Full Name | Carrillo Medical Group Professional Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 1800 Sullivan Ave Rm 101, Daly City, California |
| Authorized Official Name and Position | Ines Sjogrell (MANAGER) |
| Authorized Official Contact | 9257900760 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carrillo Medical Group Professional Corporation 1800 Sullivan Ave Rm 101 Daly City CA 94015-2227 Ph: (650) 994-0459 | Carrillo Medical Group Professional Corporation 1800 Sullivan Ave Rm 101 Daly City CA 94015-2227 Ph: (650) 994-0459 |
| NPI Number | 1730223421 |
|---|---|
| Provider Enumeration Date | 02/16/2007 |
| Last Update Date | 09/15/2015 |
| Medicare PECOS PAC ID | 1052342029 |
|---|---|
| Medicare Enrollment ID | O20050830000368 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730223421 | NPI | - | NPPES |
| 00A517430 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A51743 (California) | Primary |
| Provider Name | Lornalyn J Carrillo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558383844 PECOS PAC ID: 8123059110 Enrollment ID: I20050901000433 |
| Provider Name | Connie Y Tan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679211015 PECOS PAC ID: 8527442607 Enrollment ID: I20220909000134 |
Pediahealth Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 Campus Dr, Suite 210, Daly City, CA 94015 Phone: 650-994-3000 | |
John W. Wilson, Md, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1800 Sullivan Ave, Room 503, Daly City, CA 94015 Phone: 650-994-9090 Fax: 650-994-9093 | |
County Of San Mateo Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 350 90th Street, Daly City, CA 94015 Phone: 650-985-7000 Fax: 605-301-8626 | |
Divya R Kini Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1500 Southgate Avenue, Divya Kini Md Inc Suite 204, Daly City, CA 94015 Phone: 650-755-2192 Fax: 650-745-0710 | |
North East Medical Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 211 Eastmoor Ave, Daly City, CA 94015 Phone: 415-391-9686 | |
Medisina Sa Familia, Pa, Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1850 Sullivan Ave Ste 510, Daly City, CA 94015 Phone: 650-580-6479 Fax: 650-735-5580 | |
Insite Digestive Health Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1850 Sullivan Ave Ste 520, Daly City, CA 94015 Phone: 650-756-5000 |