Arch Street Medical Associates | |
143 Birch Street Redwood City CA 94062 | |
(650) 366-1141 | |
(650) 366-1265 |
Full Name | Arch Street Medical Associates |
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Speciality | General Practice |
Location | 143 Birch Street, Redwood City, California |
Authorized Official Name and Position | Peter J Bulluck (CEO) |
Authorized Official Contact | 6503661141 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Arch Street Medical Associates 143 Birch Street Redwood City CA 94062 Ph: (650) 366-1141 | Arch Street Medical Associates 143 Birch Street Redwood City CA 94062 Ph: (650) 366-1141 |
NPI Number | 1396041208 |
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Provider Enumeration Date | 02/10/2011 |
Last Update Date | 02/11/2011 |
Medicare PECOS PAC ID | 4688812480 |
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Medicare Enrollment ID | O20130606000716 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396041208 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | A31093 (California) | Primary |
Provider Name | Peter J Bullock |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1548299027 PECOS PAC ID: 0446291884 Enrollment ID: I20050517000232 |
Provider Name | Abraham Hafiz Rodriguez |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1851731616 PECOS PAC ID: 2567606924 Enrollment ID: I20200115000273 |
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