Provider Demographics
NPI:1497826283
Name:ARIAS-VERA, JOSE R
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:R
Last Name:ARIAS-VERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 EAST ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2013
Mailing Address - Country:US
Mailing Address - Phone:925-603-1363
Mailing Address - Fax:925-603-1367
Practice Address - Street 1:2211 EAST ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2013
Practice Address - Country:US
Practice Address - Phone:925-603-1363
Practice Address - Fax:925-603-1367
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD11088207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RII25109Medicare UPIN
RI007058281Medicare PIN