Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | E25237 | CA |
NPI | 1003022120 |
---|---|
Provider Name | Maureen Vieira |
First Address | Modesto, CA 95350-4447 |
Second Address | Modesto, CA 95350-4447 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 04/05/2017 |