Provider Demographics
NPI:1013299627
Name:DALPRAT, JOSE RICARDO (DO)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:RICARDO
Last Name:DALPRAT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17861 TACOMA CIR
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:92861-6362
Mailing Address - Country:US
Mailing Address - Phone:714-362-7548
Mailing Address - Fax:
Practice Address - Street 1:6025 N FIGUEROA ST STE B
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-1365
Practice Address - Country:US
Practice Address - Phone:323-507-2311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11851207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine