| Edgardo G. Alicaway, M. D., P. C. | |
|
1800 Sullivan Ave Suite 508 Daly City CA 94015-2228 | |
| (650) 756-2597 | |
| (650) 756-6371 |
| Full Name | Edgardo G. Alicaway, M. D., P. C. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1800 Sullivan Ave, Daly City, California |
| Authorized Official Name and Position | Edgardo Genebraldo Alicaway (OWNER) |
| Authorized Official Contact | 6507562597 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edgardo G. Alicaway, M. D., P. C. 1800 Sullivan Ave Suite 508 Daly City CA 94015-2228 Ph: (650) 756-2597 | Edgardo G. Alicaway, M. D., P. C. 1800 Sullivan Ave Suite 508 Daly City CA 94015-2228 Ph: (650) 756-2597 |
| NPI Number | 1760718670 |
|---|---|
| Provider Enumeration Date | 10/28/2009 |
| Last Update Date | 10/28/2009 |
| Medicare PECOS PAC ID | 6305029174 |
|---|---|
| Medicare Enrollment ID | O20110331000938 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760718670 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | A50500 (California) | Primary |
| Provider Name | Edgardo G Alicaway |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912954298 PECOS PAC ID: 1658471347 Enrollment ID: I20070710000889 |
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