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NPI Code Detail

MEDICARE: MARIA ADELMA PUNO M.D.

MEDICARE: MARIA ADELMA PUNO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMP079587MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24301079587OTHERMISTATE LICENSE NUMBER

General Provider Information

NPI Number : 1659470789
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA ADELMA PUNO M.D.
Provider Business Mailing Address
First Line : 1550 GATEWAY BLVD
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-6901
Country : US
Telephone Number : 707-427-4025
Fax Number : 707-427-4335
Provider Business Practice Location Address
First Line : 1550 GATEWAY BLVD
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-6901
Country : US
Telephone Number : 707-427-4025
Fax Number : 707-427-4335
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 01/10/2022

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Directions to “ MARIA ADELMA PUNO M.D.” Practice Location

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