VIRGILIO C. ERESO M.D. INC. NPI 1063698041

NPI Information

VIRGILIO C. ERESO M.D. INC. is a primary care clinic center in Modesto, CA. VIRGILIO C. ERESO M.D. INC. NPI is 1063698041. The provider is registered as an organization entity type.

The provider's business location address is:

500 COFFEE RD
SUITE A
MODESTO, CA
ZIP 95355-926
Phone: (209) 579-7461
Fax: (209) 579-7465

The provider's authorized official is Virgilio C. Ereso .
The authorized official title is President and has the following contact phone number (209) 579-7461.

The CLIA number assigned to this NPI record is 05D0609827 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/21/2008 and was last updated on 1/23/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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