Organization
OAKDALE FAMILY PRACTICE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GENE WAYNE VELASCO MD (OWNER)
(763) 529-9131
Entity
Organization
Contact information
Practice address
3366 OAKDALE AVE N, SUITE 403, ROBBINSDALE, MN 55422-2948
(763) 529-9131
(763) 529-5519
Mailing address
3366 OAKDALE AVE N, SUITE 403, ROBBINSDALE, MN 55422-2948
(763) 529-9131
(763) 529-5519
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
24D0670882
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06744HA
BCBS MN
MN
01
—
487659600
DEPT OF LABOR
—
05
—
767798700
—
MN
01
—
CH8589
RAILROAD MEDICARE
—
01
—
NA376
PREFERRED ONE
MN
01
—
P153
UCARE
MN
Enumeration date
10/11/2006
Last updated
05/16/2008
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