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PAJARO VALLEY MEDICAL CLINIC INC. NPI 1679509798


NPI Information

NPI: 1679509798
Provider Name: PAJARO VALLEY MEDICAL CLINIC, INC.
Classification: Family Medicine - 207QG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

CLIA Number: 05D1055254

Address:
65 NIELSON ST
STE 104
WATSONVILLE, CA
ZIP 95076
Phone: (831) 786-8595
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PAJARO VALLEY MEDICAL CLINIC, INC. is a geriatric medicine family medicine in Watsonville, CA. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. PAJARO VALLEY MEDICAL CLINIC, INC. NPI is 1679509798. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

65 NIELSON ST
STE 104
WATSONVILLE, CA
ZIP 95076-491
Phone: (831) 786-8595
Fax: (831) 786-8557

The provider's authorized official is Christopher John O'grady .
The authorized official title is Physician / Owner and has the following contact phone number (831) 786-8595.

The CLIA number assigned to this NPI record is 05D1055254 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/23/2006 and was last updated on 9/27/2010.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207QG0300XFamily MedicineGeriatric MedicineYes

Other Identifiers

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

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1ZZZ03561ZMEDICARE ID-TYPE UNSPECIFIEDGROUP PROVIDER ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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