Basic Information
| Provider Information | |||||||||
| NPI: | 1134411549 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PINNACLE HEALTHCARE MEDICAL GROUP-WATSONVILLE, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | PINNACLE HEALTHCARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4 ROSSI CIR STE 101 | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939072358 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317574444 | ||||||||
| FaxNumber: | 8317574419 | ||||||||
| Practice Location | |||||||||
| Address1: | 591 MCCRAY ST STE 101 | ||||||||
| Address2: | |||||||||
| City: | HOLLISTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316344444 | ||||||||
| FaxNumber: | 8316344440 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2011 | ||||||||
| LastUpdateDate: | 12/31/2020 | ||||||||
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| AuthorizedOfficialLastName: | ALVERO | ||||||||
| AuthorizedOfficialFirstName: | ERNESTO | ||||||||
| AuthorizedOfficialMiddleName: | M. | ||||||||
| AuthorizedOfficialTitleorPosition: | C.E.O. | ||||||||
| AuthorizedOfficialTelephone: | 8317574444 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | P.A. | ||||||||
| NPICertificationDate: | 12/31/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.