Healthcare Provider Details

I. General information

NPI: 1003148222
Provider Name (Legal Business Name): VICTORIA R. OIRA MD, FAAP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2010
Last Update Date: 02/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

890 EASTLAKE PKWY 203
CHULA VISTA CA
91914-4520
US

IV. Provider business mailing address

890 EASTLAKE PKWY 203
CHULA VISTA CA
91914-4520
US

V. Phone/Fax

Practice location:
  • Phone: 619-656-3020
  • Fax: 619-656-3019
Mailing address:
  • Phone: 619-656-3020
  • Fax: 619-656-3019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA051972
License Number StateCA

VIII. Authorized Official

Name: DR. VICTORIA RAMOS OIRA
Title or Position: PRESIDENT
Credential: MD
Phone: 619-656-3020