Healthcare Provider Details

I. General information

NPI: 1669680351
Provider Name (Legal Business Name): MARIA CORAZON MATIAS PIANSAY MD, MPH, FAAP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 08/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1935 CORTE VERBENA
CHULA VISTA CA
91914-4619
US

IV. Provider business mailing address

1935 CORTE VERBENA
CHULA VISTA CA
91914-4619
US

V. Phone/Fax

Practice location:
  • Phone: 619-464-1794
  • Fax: 619-464-3894
Mailing address:
  • Phone: 619-464-1794
  • Fax: 619-464-3894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA93785
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: