A & I Huatuco, Inc.
Organization Active NPI Specialist · Tracy, CA
NPI 1114003605 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1114003605
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- Legal business name
- A & I HUATUCO, INC.
- Practice address
- 1530 Bessie Ave Ste 102
Tracy, CA 95376-3080 - Phone
- (209) 836-1627
- Fax
- (209) 836-5478
- NPI assigned
- Oct 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Aibar Herberto Huatuco, MD
- Title
- President
- Phone
- (209) 836-1627
Practitioners 1
-
Aibar Herberto Huatuco, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040825001699 | CA | Part B Supplier - Clinic/Group Practice | 6800860669 |
Receives reassigned benefits from 1 practitioner Practice locations: Tracy, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | Yes |
Addresses
Primary practice location
1530 Bessie Ave Ste 102
Tracy, CA 95376-3080
Mailing address
1530 Bessie Ave Ste 102
Tracy, CA 95376-3080
Phone (209) 836-1627
Other names
- Aibar Huatuco, M.D.
Other providers in Tracy, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.