| Rio Del Mar Medical Clinic | |
|
10 W 5th St Watsonville CA 95076-4202 | |
| (831) 722-4016 | |
| (831) 722-8048 |
| Full Name | Rio Del Mar Medical Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 10 W 5th St, Watsonville, California |
| Authorized Official Name and Position | Elias S Rodriguez (OWNER) |
| Authorized Official Contact | 8317224016 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rio Del Mar Medical Clinic 10 W 5th St Watsonville CA 95076-4202 Ph: (831) 722-4016 | Rio Del Mar Medical Clinic 10 W 5th St Watsonville CA 95076-4202 Ph: (831) 722-4016 |
| NPI Number | 1073726246 |
|---|---|
| Provider Enumeration Date | 05/07/2007 |
| Last Update Date | 12/27/2011 |
| Medicare PECOS PAC ID | 3173569183 |
|---|---|
| Medicare Enrollment ID | O20050629001238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073726246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G77669 (California) | Primary |
| Provider Name | Elias S Rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730295395 PECOS PAC ID: 1557425501 Enrollment ID: I20090205000537 |
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