| Daryl R Dutter Md Inc | |
|
521 N Wilma Ave Ste A Ripon CA 95366-9503 | |
| (209) 599-4211 | |
| (209) 599-7348 |
| Full Name | Daryl R Dutter Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 521 N Wilma Ave Ste A, Ripon, California |
| Authorized Official Name and Position | Daryl R Dutter (PRESIDENT) |
| Authorized Official Contact | 2095994211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Daryl R Dutter Md Inc Po Box 210 Ripon CA 95366-0210 Ph: (209) 599-4211 | Daryl R Dutter Md Inc 521 N Wilma Ave Ste A Ripon CA 95366-9503 Ph: (209) 599-4211 |
| NPI Number | 1992025332 |
|---|---|
| Provider Enumeration Date | 06/08/2010 |
| Last Update Date | 01/03/2022 |
| Medicare PECOS PAC ID | 7719001601 |
|---|---|
| Medicare Enrollment ID | O20100830000435 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992025332 | NPI | - | NPPES |
| 00G572330 | Medicaid | CA | |
| 080009801 | Other | CA | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G57233 (California) | Primary |
| Provider Name | Daryl R Dutter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578568366 PECOS PAC ID: 3072648203 Enrollment ID: I20100312000888 |
| Provider Name | Vincent Lamarr Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063633758 PECOS PAC ID: 3870892565 Enrollment ID: I20160504001449 |
| Provider Name | Blake A Hufford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114559648 PECOS PAC ID: 8224466511 Enrollment ID: I20200413000231 |
Ripon Primary & Urgent Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 336 W Main St, Ripon, CA 95366 Phone: 209-599-5571 Fax: 209-253-0700 | |
James Jeffrey Daley Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 521 N Wilma Ave Ste A, Ripon, CA 95366 Phone: 209-599-4211 Fax: 209-599-7348 | |
Ripon Family Physicians Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 521 N Wilma Ave Ste A, Ripon, CA 95366 Phone: 209-599-4211 Fax: 209-599-7348 | |
Ripon Primary & Urgent Care Center A Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 336 W Main St, Ripon, CA 95366 Phone: 209-599-5571 Fax: 209-253-0701 |