| Oliveira Medical Inc | |
|
506 W Graham Ave Ste 107 Lake Elsinore CA 92530 | |
| (951) 471-5116 | |
| (951) 471-5226 |
| Full Name | Oliveira Medical Inc |
|---|---|
| Speciality | General Practice |
| Location | 506 W Graham Ave, Lake Elsinore, California |
| Authorized Official Name and Position | Thomas Edward Oliveira (OWNER) |
| Authorized Official Contact | 9514715116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oliveira Medical Inc 506 W Graham Ave Ste 107 Lake Elsinore CA 92530 Ph: (951) 471-5116 | Oliveira Medical Inc 506 W Graham Ave Ste 107 Lake Elsinore CA 92530 Ph: (951) 471-5116 |
| NPI Number | 1518076256 |
|---|---|
| Provider Enumeration Date | 08/29/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8426247735 |
|---|---|
| Medicare Enrollment ID | O20110118000500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518076256 | NPI | - | NPPES |
| 00AX70320 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 20A7032 (California) | Primary |
| Provider Name | Thomas E Oliveira |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124291828 PECOS PAC ID: 1557307717 Enrollment ID: I20050628001413 |
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