| Parra Medical Clinic, Inc. | |
|
2820 Alum Rock Ave Suite 10 San Jose CA 95127-5608 | |
| (408) 254-5040 | |
| (408) 254-5044 |
| Full Name | Parra Medical Clinic, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 2820 Alum Rock Ave, San Jose, California |
| Authorized Official Name and Position | Caroline S. Parra (OFFICE MANAGER) |
| Authorized Official Contact | 4082545040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Parra Medical Clinic, Inc. 2820 Alum Rock Ave Suite 10 San Jose CA 95127-5608 Ph: (408) 254-5040 | Parra Medical Clinic, Inc. 2820 Alum Rock Ave Suite 10 San Jose CA 95127-5608 Ph: (408) 254-5040 |
| NPI Number | 1710085055 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 12/09/2011 |
| Medicare PECOS PAC ID | 2466434485 |
|---|---|
| Medicare Enrollment ID | O20040603000784 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710085055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Gustavo Parra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912922840 PECOS PAC ID: 7517949530 Enrollment ID: I20040608000877 |
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