| Perris Valley Clinica Medica Familiar | |
|
735 S D St Perris CA 92570-2419 | |
| (951) 657-3177 | |
| (951) 657-4467 |
| Full Name | Perris Valley Clinica Medica Familiar |
|---|---|
| Speciality | Family Medicine |
| Location | 735 S D St, Perris, California |
| Authorized Official Name and Position | Octavio Ruiz-villalpando (PRESIDENT) |
| Authorized Official Contact | 9516573177 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Perris Valley Clinica Medica Familiar 735 S D St Perris CA 92570-2419 Ph: (951) 657-3177 | Perris Valley Clinica Medica Familiar 735 S D St Perris CA 92570-2419 Ph: (951) 657-3177 |
| NPI Number | 1154420933 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 07/10/2015 |
| Medicare PECOS PAC ID | 4486695616 |
|---|---|
| Medicare Enrollment ID | O20050518000853 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154420933 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (California) | Primary |
| Provider Name | Octavio Ruiz Villalpando |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194832816 PECOS PAC ID: 3870691926 Enrollment ID: I20070613000358 |
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