Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 95003809 | CA |
NPI | 1215382874 |
---|---|
Provider Name | Nancy Pulido |
First Address | Fontana, CA 92336-3329 |
Second Address | Fontana, CA 92336-3329 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2016 |
Last Update Date | 02/05/2016 |