Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | PENDING | CA |
N | 213EG0000X | General Practice | PENDING | CA |
Y | 1223P0221X | Pediatric Dentist | 59202 | CA |
NPI | 1053541763 |
---|---|
Provider Name | Dr. Cheryl Estiva |
First Address | San Diego, CA 92123-1481 |
Second Address | Escondido, CA 92025-6428 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2009 |
Last Update Date | 05/02/2013 |