Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A87032 | CA |
N | 2080P0208X | Pediatric Infectious Diseases | A87032 | CA |
NPI | 1083894315 |
---|---|
Provider Name | Delma Julieta Nieves |
First Address | Orange, CA 92868-3874 |
Second Address | Orange, CA 92868-3874 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2007 |
Last Update Date | 26/03/2010 |