| West Pcp | |
|
Carr 113 Km 1.2 Bo Guayabo Isabela PR 00662 | |
| (787) 830-1654 | |
| (787) 830-1654 |
| Full Name | West Pcp |
|---|---|
| Speciality | General Practice |
| Location | Carr 113 Km 1.2 Bo Guayabo, Isabela, Puerto Rico |
| Authorized Official Name and Position | Santiago Rivera Ortega (PRESIDENT) |
| Authorized Official Contact | 7878301654 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Pcp Ave. Militar 3623 Pmb 492 Isabela PR 00662 Ph: (787) 830-1654 | West Pcp Carr 113 Km 1.2 Bo Guayabo Isabela PR 00662 Ph: (787) 830-1654 |
| NPI Number | 1265057863 |
|---|---|
| Provider Enumeration Date | 06/10/2020 |
| Last Update Date | 08/13/2020 |
| Medicare PECOS PAC ID | 6406272855 |
|---|---|
| Medicare Enrollment ID | O20200821002381 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265057863 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Santiago Rivera Ortega |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1730151879 PECOS PAC ID: 3274501457 Enrollment ID: I20040924000529 |
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