Danilo Reynes Cruz, M.D.

Individual provider Active NPI Family Medicine Physician · Corcoran, CA

NPI 1689889016 · NPPES record last updated Oct 29, 2009

Key facts

NPI
1689889016
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
A106250 (CA)
Practice address
1212 Hanna Ave
Corcoran, CA 93212-2313
Phone
(559) 992-2800
Fax
(559) 992-2899
NPI assigned
May 11, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20140219000305 CA Order and Referring Only - Family Practice
Practitioner - Family Practice
7810040219

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A106250CAMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A106250 CA Yes

Addresses

Primary practice location

1212 Hanna Ave
Corcoran, CA 93212-2313

Mailing address

1212 Hanna Ave
Corcoran, CA 93212-2313
Phone (559) 992-2800

Other providers in Corcoran, CA

All providers in Corcoran, CA · Family Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.