| Rodolfo B Protacio Md | |
|
710 S. Central Avenue Suite 340 Glendale CA 91204-4647 | |
| (818) 500-8739 | |
| (818) 500-0957 |
| Full Name | Rodolfo B Protacio Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 710 S. Central Avenue, Glendale, California |
| Authorized Official Name and Position | Rosalinda Valmeo Protacio (OFFICE MANAGER) |
| Authorized Official Contact | 8183957311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rodolfo B Protacio Md 710 S. Central Avenue Suite 340 Glendale CA 91204-4647 Ph: (818) 500-8739 | Rodolfo B Protacio Md 710 S. Central Avenue Suite 340 Glendale CA 91204-4647 Ph: (818) 500-8739 |
| NPI Number | 1154583193 |
|---|---|
| Provider Enumeration Date | 07/01/2008 |
| Last Update Date | 09/21/2023 |
| Medicare PECOS PAC ID | 7618038001 |
|---|---|
| Medicare Enrollment ID | O20081203000700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154583193 | NPI | - | NPPES |
| A049837 | Medicaid | CA |
| Provider Name | Rodolfo B Protacio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154320836 PECOS PAC ID: 8325942295 Enrollment ID: I20081203000679 |
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