Provider Demographics
NPI:1780650598
Name:DELGADO, RALPH J (MD)
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:J
Last Name:DELGADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5160 BREESE CIR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-7656
Mailing Address - Country:US
Mailing Address - Phone:916-390-8394
Mailing Address - Fax:888-262-0521
Practice Address - Street 1:5160 BREESE CIR
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-7656
Practice Address - Country:US
Practice Address - Phone:916-390-8394
Practice Address - Fax:888-262-0521
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG396070207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G396070Medicaid
00G396070Medicare ID - Type Unspecified
CA00G396070Medicaid