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General NPI Number Information
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NPI Number | 1346667920
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Entity Type | Organization
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Legal Business Name | GERIATRIC HOUSE CALLS OF SANTA CLARITA, INC
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Dates
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Enumeration Date | 03/21/2014
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Last Update Date | 06/12/2014
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Provider Practice Location Address
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Address Line | 24270 WALNUT STREET SUITE 102
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City | NEWHALL
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State | CA
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Zip | 91321-2852
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Country | US
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Telephone | 661-288-0081
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Fax | 661-255-8377
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Provider Business Mailing Address
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Address Line | 24270 WALNUT STREET SUITE 102
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City | NEWHALL
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State | CA
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Zip | 91321-2852
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Country | US
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Telephone | 661-288-0081
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Fax | 661-255-8377
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Authorized Official
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Title or Position | CEO
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Name | DR. RAYMOND J. DORIO
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Credential | M.D.
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Telephone | 661-288-0081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | A29371
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License Number State | CA
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