Basic Information
Provider Information
NPI: 1790708220
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RIOS
FirstName: KATHRYN
MiddleName: ELISE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 559 E ALISAL ST
Address2: SUITE 201
City: SALINAS
State: CA
PostalCode: 939052516
CountryCode: US
TelephoneNumber: 8317691304
FaxNumber: 8317570291
Practice Location
Address1: 1441 CONSTITUTION BLVD
Address2: BLDG. 200, SUITE 105
City: SALINAS
State: CA
PostalCode: 939063100
CountryCode: US
TelephoneNumber: 8317554123
FaxNumber: 8317554122
Other Information
ProviderEnumerationDate: 07/25/2006
LastUpdateDate: 02/22/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XG79251CAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home