Healthcare Provider Details

I. General information

NPI: 1275935017
Provider Name (Legal Business Name): MAGDA PERONEL NMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2014
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6620 COYLE AVE STE 400
CARMICHAEL CA
95608-6333
US

IV. Provider business mailing address

6620 COYLE AVE STE 400
CARMICHAEL CA
95608-6333
US

V. Phone/Fax

Practice location:
  • Phone: 916-850-2959
  • Fax: 844-667-7642
Mailing address:
  • Phone: 916-850-2959
  • Fax: 844-667-7642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: