| Virgilio C. Ereso M.d. Inc. | |
|
500 Coffee Rd Suite A Modesto CA 95355-4926 | |
| (209) 579-7461 | |
| (209) 579-7465 |
| Full Name | Virgilio C. Ereso M.d. Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 500 Coffee Rd, Modesto, California |
| Authorized Official Name and Position | Virgilio C. Ereso (PRESIDENT) |
| Authorized Official Contact | 2095797461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Virgilio C. Ereso M.d. Inc. 500 Coffee Rd Suite A Modesto CA 95355-4926 Ph: (209) 579-7461 | Virgilio C. Ereso M.d. Inc. 500 Coffee Rd Suite A Modesto CA 95355-4926 Ph: (209) 579-7461 |
| NPI Number | 1063698041 |
|---|---|
| Provider Enumeration Date | 01/21/2008 |
| Last Update Date | 01/23/2008 |
| Medicare PECOS PAC ID | 8426130436 |
|---|---|
| Medicare Enrollment ID | O20080130000304 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063698041 | NPI | - | NPPES |
| A303080 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A30308 (California) | Primary |
| Provider Name | Virgilio C Ereso |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720031685 PECOS PAC ID: 0345322350 Enrollment ID: I20080130000293 |
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