Basic Information
Provider Information
NPI: 1962467506
EntityType: 2
ReplacementNPI:  
OrganizationName: ERNEST F. RILLOS, M.D., P.C.
LastName:  
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Credential:  
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Mailing Information
Address1: PO BOX 27340
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850617340
CountryCode: US
TelephoneNumber: 6029439200
FaxNumber: 6022163000
Practice Location
Address1: 2281 W 24TH ST
Address2: 15
City: YUMA
State: AZ
PostalCode: 853646154
CountryCode: US
TelephoneNumber: 9283178554
FaxNumber: 9287269067
Other Information
ProviderEnumerationDate: 04/18/2006
LastUpdateDate: 12/06/2007
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: RILLOS
AuthorizedOfficialFirstName: ERNEST
AuthorizedOfficialMiddleName: FELIX
AuthorizedOfficialTitleorPosition: PRESIDENT/OWNER
AuthorizedOfficialTelephone: 9283178554
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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