Provider Demographics
NPI:1790708220
Name:RIOS, KATHRYN ELISE (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:ELISE
Last Name:RIOS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:559 E ALISAL ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-2516
Mailing Address - Country:US
Mailing Address - Phone:831-769-1304
Mailing Address - Fax:831-757-0291
Practice Address - Street 1:1441 CONSTITUTION BLVD
Practice Address - Street 2:BLDG. 200, SUITE 105
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3100
Practice Address - Country:US
Practice Address - Phone:831-755-4123
Practice Address - Fax:831-755-4122
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2010-02-22
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Provider Licenses
StateLicense IDTaxonomies
CAG79251207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG22483Medicare UPIN
CAZZZ02040ZMedicare ID - Type UnspecifiedCOUNTY OF MONTEREY GROUP