Individual ProviderAdalberto RenteriaFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1524 W Lacey Blvd, Hanford, CA 93230-5965(559) 537-0053(916) 865-1790PECOS EnrollmentBased on the most recent information from CMS, provider Adalberto Renteria is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1619948502Provider TypeIndividualFull NameRenteria, AdalbertoCredentialMDGenderMaleSole ProprietorNoEnumeration Date1/30/2006Last Updated8/11/2014Contact InformationPractice LocationPractice Address1524 W Lacey Blvd, Hanford, CA 93230-5965Phone(559) 537-0053FaxUnlisted FaxMailing LocationMailing Address2100 Douglas Blvd, Roseville, CA 95661-3804Phone(916) 865-1790FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseG65072CaliforniaCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense31454ArizonaProvider IdentifiersIDDescriptionIssuerID791914DescriptionMedicaidIssuerUnlistedArizona