| Nepomuceno, Md, Inc. | |
|
15660 Middletown Park Dr Redding CA 96001-9794 | |
| (530) 244-1003 | |
| (530) 242-6027 |
| Full Name | Nepomuceno, Md, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 15660 Middletown Park Dr, Redding, California |
| Authorized Official Name and Position | John E Nepomuceno (PRESIDENT) |
| Authorized Official Contact | 5302441003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nepomuceno, Md, Inc. Po Box 994463 Redding CA 96099-4463 Ph: (530) 244-1003 | Nepomuceno, Md, Inc. 15660 Middletown Park Dr Redding CA 96001-9794 Ph: (530) 244-1003 |
| NPI Number | 1437267911 |
|---|---|
| Provider Enumeration Date | 08/26/2006 |
| Last Update Date | 11/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437267911 | NPI | - | NPPES |
| GR0094270 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | C50728 (California) | Primary |
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