Healthcare Provider Details

I. General information

NPI: 1982632675
Provider Name (Legal Business Name): PATRICIA C APOLINARIO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 10/23/2020
Certification Date: 10/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W HOSPITAL RD
FRENCH CAMP CA
95231-9693
US

IV. Provider business mailing address

500 W HOSPITAL RD
FRENCH CAMP CA
95231-9693
US

V. Phone/Fax

Practice location:
  • Phone: 209-468-6820
  • Fax: 209-468-2321
Mailing address:
  • Phone: 209-468-6937
  • Fax: 209-468-7042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA052019
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: