Individual ProviderJesus Ricardo OdulioDentistDental ProvidersPractice Address347 Gellert Blvd Ste K, Daly City, CA 94015-2618(650) 757-5379PECOS EnrollmentBased on the most recent information from CMS, provider Jesus Ricardo Odulio does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1205989910Provider TypeIndividualFull NameOdulio, Jesus RicardoTitleDr.CredentialD.M.D.GenderMaleSole ProprietorYesEnumeration Date1/18/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address347 Gellert Blvd Ste K, Daly City, CA 94015-2618Phone(650) 757-5379Fax(650) 757-4769Mailing LocationMailing Address347 Gellert Blvd Ste K, Daly City, CA 94015-2618Phone(650) 757-5379Fax(650) 757-4769Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicense42753California