| Oliverio Medical Corporation | |
|
330 W Ramsey St Banning CA 92220-4823 | |
| (951) 849-1950 | |
| (951) 849-1892 |
| Full Name | Oliverio Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 330 W Ramsey St, Banning, California |
| Authorized Official Name and Position | Michael R Oliverio (CEO) |
| Authorized Official Contact | 9518491950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oliverio Medical Corporation 330 W Ramsey St Banning CA 92220-4823 Ph: (951) 849-1950 | Oliverio Medical Corporation 330 W Ramsey St Banning CA 92220-4823 Ph: (951) 849-1950 |
| NPI Number | 1710415492 |
|---|---|
| Provider Enumeration Date | 05/25/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 1951675073 |
|---|---|
| Medicare Enrollment ID | O20170927003571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710415492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A45042 (California) | Primary |
| Provider Name | Michael R Oliverio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063591915 PECOS PAC ID: 6305829680 Enrollment ID: I20090713000468 |
| Provider Name | Monemala Philavong-danh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093228926 PECOS PAC ID: 2769816644 Enrollment ID: I20191231001256 |
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