Healthcare Provider Details

I. General information

NPI: 1609826338
Provider Name (Legal Business Name): JULIAN L DELGADO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 08/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2967 DAVISON CT. SUITE A
COLUSA CA
95932-3263
US

IV. Provider business mailing address

700 17TH ST STE 201
MODESTO CA
95354-1249
US

V. Phone/Fax

Practice location:
  • Phone: 530-458-8050
  • Fax: 530-458-5936
Mailing address:
  • Phone: 530-458-8050
  • Fax: 530-458-5936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG55334
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: