Rick Gerald Beronilla, PA-C
Physician Assistant in Fremont, CA. Individual provider (NPI-1).
NPI number1174856603
StatusActive
Last updated in NPPESJan 26, 2024
Details
- NPI
- 1174856603
- Entity type
- Individual (NPI-1)
- Name
- Rick Gerald Beronilla
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 16, 2009
- Certification date
- Jan 26, 2024
- Last updated
- Jan 26, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA20365 | CA | Yes |
Practice location
3200 Kearney StFremont, CA 94538-2299
Phone 510-490-1222
Mailing address
325 Distel CirLos Altos, CA 94022-1408
Phone 510-490-1222 · Fax 209-383-1296
Other practice locations
821 Texas Ave
Los Banos, CA 93635-3453
Los Banos, CA 93635-3453
Phone 209-826-1045 · Fax 209-826-0952
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