Don Pedro Family Practice | |
3191 El Prado Rd Suite D La Grange CA 95329-9761 | |
(209) 852-2764 | |
(209) 852-2766 |
Full Name | Don Pedro Family Practice |
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Speciality | General Practice |
Location | 3191 El Prado Rd, La Grange, California |
Authorized Official Name and Position | Sandra Marie De La Torre (OFFICE MANAGER) |
Authorized Official Contact | 2098742345 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Don Pedro Family Practice 2416 Canasta Ct La Grange CA 95329-9633 Ph: (209) 852-2765 | Don Pedro Family Practice 3191 El Prado Rd Suite D La Grange CA 95329-9761 Ph: (209) 852-2764 |
NPI Number | 1104145861 |
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Provider Enumeration Date | 05/20/2010 |
Last Update Date | 05/20/2010 |
Medicare PECOS PAC ID | 4284758764 |
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Medicare Enrollment ID | O20100907000272 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104145861 | NPI | - | NPPES |
00A533570 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | A53357 (Connecticut) | Primary |