Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 29873 | IA |
NPI | 1033181359 |
---|---|
Provider Name | Francisco G Peralta |
First Address | Fort Dodge, IA 50501-3909 |
Second Address | Fort Dodge, IA 50501-5742 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 26/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F75885 | (02) |