Healthcare Provider Details
I. General information
NPI: 1962467506
Provider Name (Legal Business Name): ERNEST F. RILLOS, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/18/2006
Last Update Date: 12/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2281 W 24TH ST 15
YUMA AZ
85364-6154
US
IV. Provider business mailing address
PO BOX 27340
PHOENIX AZ
85061-7340
US
V. Phone/Fax
- Phone: 928-317-8554
- Fax: 928-726-9067
- Phone: 602-943-9200
- Fax: 602-216-3000
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ERNEST
FELIX
RILLOS
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 928-317-8554