Healthcare Provider Details
I. General information
NPI: 1316391113
Provider Name (Legal Business Name): PINNACLE FAMILY PRACTICE GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/18/2016
Last Update Date: 04/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2524 H DELA ROSA SR ST
SOLEDAD CA
93960-3383
US
IV. Provider business mailing address
4 ROSSI CIR SUITE 101
SALINAS CA
93907-2362
US
V. Phone/Fax
- Phone: 831-678-8899
- Fax: 831-678-4545
- Phone: 831-757-4444
- Fax: 831-757-4419
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ERNESTO
M.
ALVERO
Title or Position: C.E.O.
Credential: P.A.
Phone: 831-757-4444