| Organization Name: | OLIVEIRA MEDICAL INC |
| NPI Number: | 1518076256 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS EDWARD OLIVEIRA (OWNER) |
| Mailing Address: | 506 W Graham Ave Ste 107 Lake Elsinore |
| State: | CA US |
| Postal Code: | 92530 |
| Phone Number: | 9514715116 |
| Fax Number: | 9514715226 |
| NPI Enumeration Date: | 08/29/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 20A7032 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |