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Nicholas Daniel Urrutia

Family Medicine

Allopathic & Osteopathic Physicians

355 Campus Dr, Ste E, Hanford, CA 93230-4310

PECOS Enrollment

This provider is enrolled in PECOS as NICHOLAS URRUTIA.

Based on the most recent information from CMS, provider Nicholas Daniel Urrutia is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:47 AM.

Profile Details

Provider ID
1205171378
Provider Type
Individual
Full Name
Urrutia, Nicholas Daniel
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
11/30/2012
Last Updated
11/22/2013

Contact Information

Practice Location

355 Campus Dr, Ste E, Hanford, CA 93230-4310

(559) 584-0668

(559) 584-1071

Mailing Location

355 Campus Dr, Ste E, Hanford, CA 93230-4310

(559) 584-0668

(559) 584-1071

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License A122953 California

Provider Identifiers

ID	Description	Issuer
ID A122953	Description Other	Issuer MEDICARE California
ID A122953	Description Medicaid	Issuer Unlisted California

Nicholas Daniel Urrutia

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Jacqueline G De Castro Md Inc

Excellence Medical Group Inc

Renteria, Adalberto

Leon, Samuel O

Urrutia, Daniel

Basit Medical Inc

Majzoubi, Daria

Central Valley Comprehensive Care Inc.

Baiju Abdulla, M.B.B.S., A Professional Corporation

Miller, Dennis Keith