Provider Demographics
NPI:1720275878
Name:ROSEMARY DELGADO MD., INC
Entity Type:Organization
Organization Name:ROSEMARY DELGADO MD., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:NADINE
Authorized Official - Last Name:MAES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-937-1915
Mailing Address - Street 1:1776 YGNACIO VALLEY RD
Mailing Address - Street 2:STE 208
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3125
Mailing Address - Country:US
Mailing Address - Phone:925-937-9345
Mailing Address - Fax:925-937-1768
Practice Address - Street 1:1776 YGNACIO VALLEY RD
Practice Address - Street 2:STE 208
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3125
Practice Address - Country:US
Practice Address - Phone:925-937-9345
Practice Address - Fax:925-937-1768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA455170174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF08847Medicare UPIN
CAGMD012334Medicare PIN