Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 00G578390 | CA |
NPI | 1134192305 |
---|---|
Provider Name | Pauline Velez |
First Address | Martinez, CA 94553-4668 |
Second Address | Martinez, CA 94553-4668 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 10/07/2007 |