Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0201X | Internist - Allergy & Immunology | 25MA08204600 | NJ |
Y | 207RA0201X | Internist - Allergy & Immunology | A102716 | CA |
NPI | 1104031327 |
---|---|
Provider Name | Dr. Belle Malinit Peralejo |
First Address | Fresno, CA 93720-2457 |
Second Address | Fresno, CA 93720-2457 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 14/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GR0043790 | (05) | CA |
ZZZ21572Z | MEDICARE GROUP PTAN FOR ALL OFFICE LOCATIONS UNDER BAZ ALLERGY, ASTHMA & SINUS C (01) | CA |