Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | C159045 | CA |
NPI | 1033183553 |
---|---|
Provider Name | Maylene I Peralta |
First Address | Rancho Cordova, CA 95670-7956 |
Second Address | Redding, CA 96001-2462 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 08/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H84367 | (02) | ME |