Provider Demographics
NPI:1346667920
Name:GERIATRIC HOUSE CALLS OF SANTA CLARITA, INC
Entity Type:Organization
Organization Name:GERIATRIC HOUSE CALLS OF SANTA CLARITA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:J
Authorized Official - Last Name:DORIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-288-0081
Mailing Address - Street 1:24270 WALNUT STREET
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2852
Mailing Address - Country:US
Mailing Address - Phone:661-288-0081
Mailing Address - Fax:661-255-8377
Practice Address - Street 1:24270 WALNUT STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2852
Practice Address - Country:US
Practice Address - Phone:661-288-0081
Practice Address - Fax:661-255-8377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-21
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA29371207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty