Provider Demographics
NPI:1740453208
Name:RUFINO M. UYTINGCO, M.D. A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:RUFINO M. UYTINGCO, M.D. A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/VP
Authorized Official - Prefix:DR
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:UYTINGCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-620-3013
Mailing Address - Street 1:1145 GEER RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-3381
Mailing Address - Country:US
Mailing Address - Phone:209-668-4031
Mailing Address - Fax:
Practice Address - Street 1:1145 GEER RD
Practice Address - Street 2:SUITE A
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-3381
Practice Address - Country:US
Practice Address - Phone:209-668-4031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-05
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73254207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A732540Medicaid
CA00A732540Medicaid