Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A76652 | CA |
N | 2080P0203X | Pediatric Critical Care Doctor | A76652 | CA |
NPI | 1205972957 |
---|---|
Provider Name | Liliana Gelvez |
First Address | Visalia, CA 93291-6237 |
Second Address | Visalia, CA 93291-6237 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 17/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A766520 | (05) | CA |
I22284 | (02) |