| Paul J Percival M D Medical Corporation | |
|
591 Mccray St Suite 221 Hollister CA 95023-2224 | |
| (831) 638-9715 | |
| (831) 637-7691 |
| Full Name | Paul J Percival M D Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 591 Mccray St, Hollister, California |
| Authorized Official Name and Position | Kristen Vallejo (OFFICE MANAGER) |
| Authorized Official Contact | 8316389715 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul J Percival M D Medical Corporation 591 Mccray St Suite 221 Hollister CA 95023-2224 Ph: (831) 638-9715 | Paul J Percival M D Medical Corporation 591 Mccray St Suite 221 Hollister CA 95023-2224 Ph: (831) 638-9715 |
| NPI Number | 1770607947 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 04/19/2022 |
| Medicare PECOS PAC ID | 4082715503 |
|---|---|
| Medicare Enrollment ID | O20070726000751 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770607947 | NPI | - | NPPES |
| 1972595692 | Other | CA | IND. NPI, PAUL PERCIVAL |
| 0631829 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G83115 (California) | Primary |
| Provider Name | Dilshad M Kheraj |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467558163 PECOS PAC ID: 8022016732 Enrollment ID: I20061113000327 |
| Provider Name | Paul J Percival |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972595692 PECOS PAC ID: 4082715602 Enrollment ID: I20070726000744 |
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