Doctor Name: | DR. PAUL S. VALLEJO |
NPI Number: | 1003927203 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.M. |
License Number: | E4299 |
Business Practice Address: | 410 W Central Ave 204 Brea, CA - 928213014 |
Business Phone Number: | 7149904422 |
Business Fax Number: | |
Mailing Address: | 16606 Pennard Ln, FONTANA |
State: | CA |
Postal Code: | 923361236 |
Phone Number: | 9098222075 |
Fax Number: | 8663895723 |
NPI Enumeration Date: | 08/31/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0131X |
License Number: | E4299 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot Surgery |
Taxonomy Definition: |