Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | A053064 | CA |
NPI | 1013002716 |
---|---|
Provider Name | Dr. Melba Agatep Berbano |
First Address | Stockton, CA 95210-6676 |
Second Address | Stockton, CA 95210-6676 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 31/12/2007 |