Organization Name: | MIGUEL G. DE PERIO M.D. INC. |
NPI Number: | 1558717686 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MIGUEL G DE PERIO (OWNER/PRESIDENT) |
Mailing Address: | 14476 Alder Dr Corona |
State: | CA US |
Postal Code: | 928803517 |
Phone Number: | 9494634004 |
Fax Number: | |
NPI Enumeration Date: | 05/07/2016 |
NPI Last Update Date: | 05/07/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A43710 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |