Provider Demographics
NPI:1295265858
Name:YEPEZ BRACAMONTE, PABLO JOSE (MD)
Entity type:Individual
Prefix:
First Name:PABLO
Middle Name:JOSE
Last Name:YEPEZ BRACAMONTE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2050 S BLOSSER RD
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-7310
Mailing Address - Country:US
Mailing Address - Phone:805-361-8017
Mailing Address - Fax:805-361-8097
Practice Address - Street 1:2800 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-1311
Practice Address - Country:US
Practice Address - Phone:805-238-7250
Practice Address - Fax:805-238-0165
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2020-07-27
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Provider Licenses
StateLicense IDTaxonomies
CA165275208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics