| Eric B Raimo M D A Professional Medical Corporation | |
|
4147 Adams Ave San Diego CA 92116-2509 | |
| (619) 850-9889 | |
| (619) 281-1947 |
| Full Name | Eric B Raimo M D A Professional Medical Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4147 Adams Ave, San Diego, California |
| Authorized Official Name and Position | Eric B Raimo (PRESIDENT) |
| Authorized Official Contact | 6192811932 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eric B Raimo M D A Professional Medical Corporation 4147 Adams Ave San Diego CA 92116-2509 Ph: (619) 850-9889 | Eric B Raimo M D A Professional Medical Corporation 4147 Adams Ave San Diego CA 92116-2509 Ph: (619) 850-9889 |
| NPI Number | 1255845962 |
|---|---|
| Provider Enumeration Date | 11/17/2017 |
| Last Update Date | 06/21/2024 |
| Certification Date | 06/21/2024 |
| Medicare PECOS PAC ID | 4587923248 |
|---|---|
| Medicare Enrollment ID | O20180125002543 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255845962 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Eric B Raimo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568429389 PECOS PAC ID: 5991744872 Enrollment ID: I20050429000440 |
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